Individual provider Active NPI

Mena Vavasis, RPH

  • Pharmacist
  • Elmhurst, NY
National Provider Identifier
1578872016
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
047253 Issued in NY
Practice address
7901 Broadway
Elmhurst, NY 11373-1329
Phone
(718) 334-2451
NPI assigned
Oct 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 047253 NY Primary

Addresses

Primary practice location

7901 Broadway
Elmhurst, NY 11373-1329

Mailing address

7901 Broadway
Elmhurst, NY 11373-1329

Other names 1

  • Mena Stamatarou Former name

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
047253NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1578872016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVASIS",
        "first_name": "MENA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "047253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MENA",
            "last_name": "STAMATAROU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.

Verify at the official NPI Registry.