Active NPI
Edward Kyle Yu Cornico, PHARMD
- Pharmacist
- New York, NY
National Provider Identifier
1417701194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 071434
- Practice address
- 15 Elizabeth St
New York, NY 10013-4803 - Phone
- (212) 941-6480
- NPI assigned
- Apr 17, 2024
- Last updated
- Apr 17, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 071434 | NY | Primary |
Addresses
Primary practice location
15 Elizabeth St
New York, NY 10013-4803
Mailing address
15 Elizabeth St
New York, NY 10013-4803
Phone (212) 941-6480
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071434 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1417701194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 ELIZABETH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100134803",
"telephone_number": "212-941-6480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 ELIZABETH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100134803",
"telephone_number": "212-941-6480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNICO",
"first_name": "EDWARD",
"middle_name": "KYLE YU",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-17",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "071434",
"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 Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.