Active NPI
Simon Liu
- Pharmacist
- New York, NY
National Provider Identifier
1699245670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 064968
- Practice address
- 145 4TH Ave
New York, NY 10003-4906 - Phone
- (212) 677-0214
- NPI assigned
- Dec 3, 2018
- Last updated
- Dec 3, 2018
- 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 | 064968 | NY | Primary |
Addresses
Primary practice location
145 4TH Ave
New York, NY 10003-4906
Mailing address
1324 Avenue V
Brooklyn, NY 11229-4321
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
| License | State | Type | Specialty |
|---|---|---|---|
| 064968 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543795200000",
"number": "1699245670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1324 AVENUE V",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 4TH AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100034906",
"telephone_number": "212-677-0214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "SIMON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-03",
"last_updated": "2018-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "064968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.