Individual provider Active NPI

Anna Y Pustilnikova, RPH, PHARMD

  • Pharmacist
  • Everett, MA
National Provider Identifier
1275898801
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH26096 Issued in MA
Practice address
1 Mystic View Rd
Everett, MA 02149-2428
Phone
(617) 420-0001
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH26096 MA Primary

Addresses

Primary practice location

1 Mystic View Rd
Everett, MA 02149-2428

Mailing address

1 Mystic View Rd
Everett, MA 02149-2428
Phone (617) 420-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH26096MAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1275898801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MYSTIC VIEW RD",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492428",
            "telephone_number": "617-420-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MYSTIC VIEW RD",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492428",
            "telephone_number": "617-420-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSTILNIKOVA",
        "first_name": "ANNA",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "RPH, PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH26096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.