Active NPI
Michael Joseph Liddell, PHARMD
- Pharmacist
- North Syracuse, NY
National Provider Identifier
1982939625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 053657
- Practice address
- 3803 Brewerton Rd
North Syracuse, NY 13212-3785 - Phone
- (315) 458-0392
- NPI assigned
- Oct 14, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 053657 | NY | Primary |
Addresses
Primary practice location
3803 Brewerton Rd
North Syracuse, NY 13212-3785
Mailing address
3803 Brewerton Rd
North Syracuse, NY 13212-3785
Phone (315) 458-0392
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
| License | State | Type | Specialty |
|---|---|---|---|
| 053657 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255478400000",
"number": "1982939625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3803 BREWERTON RD",
"city": "NORTH SYRACUSE",
"state": "NY",
"postal_code": "132123785",
"telephone_number": "315-458-0392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3803 BREWERTON RD",
"city": "NORTH SYRACUSE",
"state": "NY",
"postal_code": "132123785",
"telephone_number": "315-458-0392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIDDELL",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-14",
"last_updated": "2009-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "053657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.