Lisa J Boodram, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

051829 Issued in NY

Practice address

501 Franklin Ave
Garden City, NY 11530-5807

Phone

(516) 307-5895

NPI assigned

Aug 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1218844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1861648222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12411 LINDEN BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202013",
            "telephone_number": "718-738-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305807",
            "telephone_number": "516-307-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOODRAM",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-16",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "051829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE",
            "identifier": "051829",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert J Bonasera, M.D.
• Sara Silveria Bonasia
• Heidi Christine Bongiorno, OTR/L
• Vincent Bonilla
• Laura Bonomo, PH.D.
• Jennifer Booth, APRN
• Kim Boral, NP
• Lara Borg, MSOTRL
• Emily Helen Borghardt, LMSW
• Boris Khaimov, DO PLLC

• Pharmacist in Garden City, NY
• Providers in Garden City, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.