Active NPI
Jason Ly, PHARMD
- Pharmacist
- Staten Island, NY
National Provider Identifier
1457673642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051956
- Practice address
- 250 Page Ave
Staten Island, NY 10307-1113 - Phone
- (718) 966-6606
- NPI assigned
- Feb 16, 2010
- Last updated
- Feb 16, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051956 | NY | Primary |
| Pharmacist | 183500000X | 28RI03162800 | NJ |
Addresses
Primary practice location
250 Page Ave
Staten Island, NY 10307-1113
Mailing address
250 Page Ave
Staten Island, NY 10307-1113
Phone (718) 966-6606
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 |
|---|---|---|---|
| 28RI03162800 | NJ | MD | Pharmacist |
| 051956 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266278400000",
"number": "1457673642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 PAGE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103071113",
"telephone_number": "718-966-6606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 PAGE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103071113",
"telephone_number": "718-966-6606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "JASON",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-16",
"last_updated": "2010-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "051956",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03162800",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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- Jennifer S Lynch, LCSW-R
- Kristine Lyne III, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.