Active NPI
Lyudmila Pekarsky, M.D
- Pediatric Adolescent Medicine Physician
- Staten Island, NY
National Provider Identifier
1497815773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 167337
- Practice address
- 356 Delaware Ave
Staten Island, NY 10305-2306 - Phone
- (718) 667-6354
- NPI assigned
- Dec 9, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 167337 | NY | Primary |
Addresses
Primary practice location
356 Delaware Ave
Staten Island, NY 10305-2306
Mailing address
16 Manor Dr
Manalapan, NJ 07726-3120
Phone (732) 972-2805
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 167337 | NY | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497815773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 MANOR DR",
"city": "MANALAPAN",
"state": "NJ",
"postal_code": "077263120",
"telephone_number": "732-972-2805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "356 DELAWARE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103052306",
"telephone_number": "718-667-6354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEKARSKY",
"first_name": "LYUDMILA",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "NY",
"license": "167337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.