Individual provider Active NPI

Yolanda Cuneta Bacayon

  • Pharmacist
  • Lindenhurst, NY
National Provider Identifier
1669652830
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
033719-1 Issued in NY
Practice address
457 Park Ave
Lindenhurst, NY 11757-5250
Phone
(631) 225-5480
NPI assigned
Nov 5, 2007
Last updated
Nov 5, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 033719-1 NY Primary

Addresses

Primary practice location

457 Park Ave
Lindenhurst, NY 11757-5250

Mailing address

81 Albermarle Ave
West Babylon, NY 11704-8039
Phone (631) 422-4137

Other identifiers 1

IdentifierTypeStateIssuer
01136016MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
033719-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1669652830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 ALBERMARLE AVE",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117048039",
            "telephone_number": "631-422-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 PARK AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117575250",
            "telephone_number": "631-225-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACAYON",
        "first_name": "YOLANDA",
        "middle_name": "CUNETA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "033719-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01136016",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.