Individual provider Active NPI

Shanyong Lin

  • Pharmacist
  • Syracuse, NY
National Provider Identifier
1871825430
Registry record updated Dec 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20054213 Issued in NY
Practice address
522 W Onondaga St
Syracuse, NY 13204-3225
Phone
(315) 475-1366
NPI assigned
Feb 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20054213 NY Primary

Addresses

Primary practice location

522 W Onondaga St
Syracuse, NY 13204-3225

Mailing address

45 Netherwood Dr
Albertson, NY 11507-1310

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Pharmacy

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
20054213NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576281600000",
    "number": "1871825430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 NETHERWOOD DR",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115071310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W ONONDAGA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132043225",
            "telephone_number": "315-475-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "SHANYONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-08",
        "last_updated": "2019-12-14",
        "certification_date": "2019-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20054213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pharmacy",
            "affiliation": "N",
            "address_1": "522 W Onondaga St",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132043225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2019; 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.