Individual provider Active NPI

Lucia Li Wang, PHARMD.

  • Pharmacist
  • New York, NY
National Provider Identifier
1417656679
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
064396 Issued in NY
Practice address
1111 Amsterdam Ave.
Clark/S&R Building, 10TH FL. Suite 8-1011
New York, NY 10025-1002
Phone
(212) 523-9202
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 064396 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave.
Clark/S&R Building, 10TH FL. Suite 8-1011
New York, NY 10025-1002

Mailing address

3960 54TH St Apt 7F
Woodside, NY 11377-4216
Phone (718) 288-2046

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
064396NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1417656679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 54TH ST APT 7F",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774216",
            "telephone_number": "718-288-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE.",
            "address_2": "CLARK/S&R BUILDING, 10TH FL. SUITE 8-1011",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251002",
            "telephone_number": "212-523-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LUCIA",
        "middle_name": "LI",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.