Individual provider Active NPI

Manisa Tanprayoon, PHARM.D.

  • Pharmacotherapy Pharmacist
  • Astoria, NY
National Provider Identifier
1336532837
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
057823 Issued in NY
Practice address
2510 30TH Ave
Astoria, NY 11102
Phone
(718) 906-6276
NPI assigned
Mar 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02990500 NJ
Pharmacotherapy Pharmacist 1835P1200X 057823 NY Primary

Addresses

Primary practice location

2510 30TH Ave
Astoria, NY 11102

Mailing address

4850 38TH St
Apt. 7D
Long Island City, NY 11101-1948

Other practice location 1

8268 164th St
Jamaica, NY 11432-1121
Phone (718) 883-3851

Other practice location 2

111 Central Ave
Newark, NJ 07102-1909
Phone (973) 877-5025

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

State licenses

LicenseStateTypeSpecialty
28RI02990500NJMDPharmacist
057823NYMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1336532837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 38TH ST",
            "address_2": "APT. 7D",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "718-906-6276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8268 164th St",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114321121",
            "country_code": "US",
            "telephone_number": "718-883-3851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071021909",
            "country_code": "US",
            "telephone_number": "973-877-5025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANPRAYOON",
        "first_name": "MANISA",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02990500",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NY",
            "license": "057823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.