Individual provider Active NPI

Domenica Spinola Lauterborn, RPH

  • Pharmacist
  • East Northport, NY
National Provider Identifier
1487831103
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
036245 Issued in NY
Practice address
520 Larkfield Rd
East Northport, NY 11731-4202
Phone
(631) 266-5026
NPI assigned
Jan 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 036245 NY Primary

Addresses

Primary practice location

520 Larkfield Rd
East Northport, NY 11731-4202

Mailing address

7 Sean Michael CT
Farmingdale, NY 11735-2124
Phone (516) 359-7615

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
036245NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1487831103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SEAN MICHAEL CT",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352124",
            "telephone_number": "516-359-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314202",
            "telephone_number": "631-266-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTERBORN",
        "first_name": "DOMENICA",
        "middle_name": "SPINOLA",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "036245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.