Active NPI
Diana Elishaiyev
- Geriatric Pharmacist
- Bronx, NY
National Provider Identifier
1417266602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 055050
- Practice address
- 392B Bedford Park Blvd
Bronx, NY 10458-2415 - Phone
- (718) 684-8864
- Fax
- (718) 684-8865
- NPI assigned
- Oct 5, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 055050 | NY | Primary |
Addresses
Primary practice location
392B Bedford Park Blvd
Bronx, NY 10458-2415
Mailing address
10 Linden St
Woodmere, NY 11598-2620
Phone (347) 327-1141
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 |
|---|---|---|---|
| 055050 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1417266602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 LINDEN ST",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115982620",
"telephone_number": "347-327-1141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "392B BEDFORD PARK BLVD",
"city": "BRONX",
"state": "NY",
"postal_code": "104582415",
"telephone_number": "718-684-8864",
"fax_number": "718-684-8865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELISHAIYEV",
"first_name": "DIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-05",
"last_updated": "2025-11-10",
"certification_date": "2025-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "NY",
"license": "055050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.