Individual provider Active NPI

Lysamma Kuruvila, PHARMACYTECH

  • Pharmacy Technician
  • Elmhurst, NY
National Provider Identifier
1831801893
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
000401 Issued in NY
Practice address
7901 Broadway
Elmhurst, NY 11373-1329
Phone
(718) 334-2430
NPI assigned
Dec 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 000401 NY Primary

Addresses

Primary practice location

7901 Broadway
Elmhurst, NY 11373-1329

Mailing address

177 Averill Blvd
Franklin Square, NY 11010-1601
Phone (718) 290-5401

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
000401NYMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1831801893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 AVERILL BLVD",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110101601",
            "telephone_number": "718-290-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUVILA",
        "first_name": "LYSAMMA",
        "credential": "PHARMACYTECH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "NY",
            "license": "000401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.