Individual provider Active NPI

Elisha Yagudayev

  • Pharmacist
  • New York, NY
National Provider Identifier
1992571426
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
070732 Issued in NY
Practice address
129 Fulton St
New York, NY 10038-2716
Phone
(212) 233-5021
NPI assigned
Nov 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 070732 NY Primary

Addresses

Primary practice location

129 Fulton St
New York, NY 10038-2716

Mailing address

15306 77TH Ave
Flushing, NY 11367-3128
Phone (347) 327-7155

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
070732NYMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1992571426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15306 77TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673128",
            "telephone_number": "347-327-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 FULTON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382716",
            "telephone_number": "212-233-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGUDAYEV",
        "first_name": "ELISHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "070732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.