Individual provider Active NPI

Eniola Bisola Tuby-Lukan

  • Pharmacist
  • Lynn, MA
National Provider Identifier
1366920381
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH238651 Issued in MA
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

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PH238651MAMDPharmacist
PHCY-04475NHMDPharmacist

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.

Verify at the official NPI Registry.