Active NPI
Lexis Tudisco
- Pharmacist
- Islip Terrace, NY
National Provider Identifier
1811717093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 072064
- Practice address
- 825 Connetquot Ave
Islip Terrace, NY 11752-1423 - Phone
- (631) 581-5496
- NPI assigned
- Oct 14, 2024
- Last updated
- Oct 14, 2024
- 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 | 072064 | NY | Primary |
Addresses
Primary practice location
825 Connetquot Ave
Islip Terrace, NY 11752-1423
Mailing address
208 Sandpiper LN
West Babylon, NY 11704-8506
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 |
|---|---|---|---|
| 072064 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | 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": "1728864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1811717093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 SANDPIPER LN",
"city": "WEST BABYLON",
"state": "NY",
"postal_code": "117048506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 CONNETQUOT AVE",
"city": "ISLIP TERRACE",
"state": "NY",
"postal_code": "117521423",
"telephone_number": "631-581-5496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUDISCO",
"first_name": "LEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-14",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "072064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Islip Terrace, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.