Lifeline Pharmacy Incorporated

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LIFELINE PHARMACY INCORPORATED

Practice address

1807 Victory Blvd
Staten Island, NY 10314-3515

Phone

(718) 304-2211

Fax

(718) 304-2231

NPI assigned

Jun 12, 2024

Organization subpart

No

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

Authorized official

Name

Sadia Khan

Title

President

Phone

(718) 304-2211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam Kuang

  • Pharmacist
  • Staten Island, NY
  • NPI 1881556942
  NPD

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1962244657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143515",
            "telephone_number": "718-304-2211",
            "fax_number": "718-304-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143515",
            "telephone_number": "718-304-2211",
            "fax_number": "718-304-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE PHARMACY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SADIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-304-2211"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Lieberman, R.N, LMHC
• Elaine Liebman, MSED
• Liezl Villaverde, MD PC
• Life Skills Enhancement Occupational Therapy Services, PC
• Lifeline Imaging LLC
• Lifes Bounty Medical Care P C
• Lifespire, Inc.
• Lifespire, Inc.
• Lifespire, Inc.
• Lifestyle Rehab PT PC

• Pharmacy in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.