Individual provider Active NPI

Yuliya Leydeker, PHARM D, BCMTMS

  • Pharmacist
  • Ozone Park, NY
National Provider Identifier
1942653183
Registry record updated Dec 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
057461 Issued in NY
Practice address
8302 Atlantic Ave
Ozone Park, NY 11416-1224
Phone
(718) 296-2153
NPI assigned
Jul 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03764200 NJ
Pharmacist 183500000X 057461 NY Primary

Addresses

Primary practice location

8302 Atlantic Ave
Ozone Park, NY 11416-1224

Mailing address

8302 Atlantic Ave
Ozone Park, NY 11416-1224
Phone (718) 296-2153

Other practice location 1

790 Park Pl
Long Beach, NY 11561-2111
Phone (516) 536-0800

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
057461NYMDDentist
28RI03764200NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC PastSince Dec 16, 2020 Accepting new patients
CVS Albany LLC PastSince Dec 16, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607817600000",
    "number": "1942653183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8302 ATLANTIC AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114161224",
            "telephone_number": "718-296-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8302 ATLANTIC AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114161224",
            "telephone_number": "718-296-2153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 Park Pl",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "NY",
            "postal_code": "115612111",
            "country_code": "US",
            "telephone_number": "516-536-0800",
            "fax_number": "516-705-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEYDEKER",
        "first_name": "YULIYA",
        "name_prefix": "Dr.",
        "credential": "PHARM D, BCMTMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2020-12-13",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03764200",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "057461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2020; 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.