Active NPI
Lukas Waller, PHARM. D
- Pharmacist
- Albany, NY
National Provider Identifier
1558777805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 052722
- Practice address
- 315 S Manning Blvd
Albany, NY 12208-1707 - Phone
- (518) 525-1616
- NPI assigned
- Jul 8, 2014
- Sex
- Male
- Sole proprietor
- No
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 | 052722 | NY | Primary |
Addresses
Primary practice location
315 S Manning Blvd
Albany, NY 12208-1707
Mailing address
4 Carriage Run
Burnt Hills, NY 12027-9447
Phone (585) 737-3280
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 |
|---|---|---|---|
| 052722 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404777600000",
"number": "1558777805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 CARRIAGE RUN",
"city": "BURNT HILLS",
"state": "NY",
"postal_code": "120279447",
"telephone_number": "585-737-3280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 S MANNING BLVD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122081707",
"telephone_number": "518-525-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLER",
"first_name": "LUKAS",
"credential": "PHARM. D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-08",
"last_updated": "2014-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "052722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.