Active NPI
Eniola Bisola Tuby-Lukan
- Pharmacist
- Lynn, MA
National Provider Identifier
1366920381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH238651
- Practice address
- 270 Union St
Lynn, MA 01901-1348 - Phone
- (781) 593-4805
- Fax
- (781) 593-5275
- NPI assigned
- Aug 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHCY-04475 | NH | |
| Pharmacist | 183500000X | PH238651 | MA | Primary |
Addresses
Primary practice location
270 Union St
Lynn, MA 01901-1348
Mailing address
130 Harvard St
Malden, MA 02148-7903
Other practice location 1
53 Church St
Kingston, NH 03848-9997
Phone (603) 642-3191
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH238651 | MA | MD | Pharmacist |
| PHCY-04475 | NH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555977600000",
"number": "1366920381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 HARVARD ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021487903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 UNION ST",
"city": "LYNN",
"state": "MA",
"postal_code": "019011348",
"telephone_number": "781-593-4805",
"fax_number": "781-593-5275"
}
],
"practiceLocations": [
{
"address_1": "53 Church St",
"address_purpose": "LOCATION",
"city": "Kingston",
"state": "NH",
"postal_code": "038489997",
"country_code": "US",
"telephone_number": "603-642-3191",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TUBY-LUKAN",
"first_name": "ENIOLA",
"middle_name": "BISOLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-01",
"last_updated": "2019-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "PHCY-04475",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH238651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.