Active NPI
Susan L Cuculich
- Pharmacist
- Liverpool, NY
National Provider Identifier
1730365883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 035481
- Practice address
- 4975 Bear Rd
Liverpool, NY 13088-4156 - Phone
- (315) 451-7454
- Fax
- (315) 451-4848
- NPI assigned
- Jan 18, 2008
- Sex
- Female
- 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 | 035481 | NY | Primary |
Addresses
Primary practice location
4975 Bear Rd
Liverpool, NY 13088-4156
Mailing address
4975 Bear Rd
Liverpool, NY 13088-4156
Phone (315) 451-7454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01201014 | Medicaid | NY |
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 |
|---|---|---|---|
| 035481 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200614400000",
"number": "1730365883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4975 BEAR RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130884156",
"telephone_number": "315-451-7454",
"fax_number": "315-451-4848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4975 BEAR RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130884156",
"telephone_number": "315-451-7454",
"fax_number": "315-451-4848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUCULICH",
"first_name": "SUSAN",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-18",
"last_updated": "2008-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "035481",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01201014",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.