Lisa Mostafavifar, PHARM.D.

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

03230809 Issued in OH

Practice address

410 W 10TH Ave
Columbus, OH 43210-1240

Phone

(614) 366-7821

NPI assigned

Oct 9, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Lisa Glance Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1548664261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVENUE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432103696",
            "telephone_number": "614-366-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-366-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTAFAVIFAR",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "03230809",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WV",
            "license": "RP0007102",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS44772",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "GLANCE",
            "prefix": "DR.",
            "credential": "PHARM.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Michael Mossner, MD, MS
• Jennifer Lynn Mossor, APRN-CNP
• Natalie A Mostacada, APRN-CNS
• Ahmed Mostafa
• Ahmad M. Mostafavifar, M.D.
• Jacqueline Kara Mostow, MD
• Raven-Symone Moten, LCSW
• Mother Angeline McCrory Manor, Inc.
• Jessica Leigh Motley, DO, ATC
• Kelita Motley

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Columbus, OH
• Providers in Columbus, OH by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; 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.