Individual provider Active NPI

Maria Cocorikas-Mauceri

  • Pharmacist
  • Stony Brook, NY
National Provider Identifier
1790157691
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
39397 Issued in NY
Practice address
25 Madeley LN
Stony Brook, NY 11790-2822
Phone
(631) 741-8614
NPI assigned
Oct 30, 2015
Last updated
Oct 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 39397 NY Primary

Addresses

Primary practice location

25 Madeley LN
Stony Brook, NY 11790-2822

Mailing address

25 Madeley LN
Stony Brook, NY 11790-2822
Phone (631) 741-8614

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
39397NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1790157691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MADELEY LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902822",
            "telephone_number": "631-741-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MADELEY LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902822",
            "telephone_number": "631-741-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCORIKAS-MAUCERI",
        "first_name": "MARIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "39397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.