Individual provider Active NPI

Stefanie Dela Cruz

  • Pharmacist
  • Bayside, NY
National Provider Identifier
1366085904
Registry record updated Oct 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
060161 Issued in NY
Practice address
20848 Cross Island Pkwy
Bayside, NY 11360-1187
Phone
(718) 751-9911
NPI assigned
Oct 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 060161 NY Primary

Addresses

Primary practice location

20848 Cross Island Pkwy
Bayside, NY 11360-1187

Mailing address

8415 Corona Ave
Elmhurst, NY 11373-5838

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

State licenses

LicenseStateTypeSpecialty
060161NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1235732926 CurrentSince Nov 22, 2020 Accepting new patients

Locations

20848 Cross Island Pkwy
Bayside, NY 11360
Phone (718) 751-9911

NPI Registry JSON

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

{
    "created_epoch": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572134400000",
    "number": "1366085904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 CORONA AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20848 CROSS ISLAND PKWY",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601187",
            "telephone_number": "718-751-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "STEFANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2019-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "060161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2019; 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.