Individual provider Active NPI

Panida Lausangngam, RPH

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1881011336
Registry record updated Mar 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
058462 Issued in NY
Practice address
911 Manhattan Ave
Brooklyn, NY 11222-5958
Phone
(718) 383-7822
NPI assigned
Mar 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 058462 NY Primary

Addresses

Primary practice location

911 Manhattan Ave
Brooklyn, NY 11222-5958

Mailing address

911 Manhattan Ave
Brooklyn, NY 11222-5958
Phone (718) 383-7822

Other names 1

  • Panida Iyimapun Former name

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
058462NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1395446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395446400000",
    "number": "1881011336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 MANHATTAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112225958",
            "telephone_number": "718-383-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 MANHATTAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112225958",
            "telephone_number": "718-383-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUSANGNGAM",
        "first_name": "PANIDA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-22",
        "last_updated": "2014-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "058462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PANIDA",
            "last_name": "IYIMAPUN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2014; 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.