NPI Code Detail JSON Logo

1548583495 NPI number — LISA DIDOMENICO PHARMD

NPI Number: 1548583495
Health Care Provider/Practitioner: LISA DIDOMENICO PHARMD

Information about “1548583495” NPI (LISA DIDOMENICO PHARMD) exists in 1548583495 in HTML format HTML  |  1548583495 in plain Text format TXT  |  1548583495 in PDF (Portable Document Format) PDF  |  1548583495 in an XML format XML  formats.

NPI Number : 1548583495 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1548583495",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DIDOMENICO",
    "FirstName": "LISA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PHARMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4280 SALISBURY RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BEMUS POINT",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14712-9747",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "716-386-5431",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "110 S WORK ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FALCONER",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14733-1434",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "716-665-2400",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/08/2010",
    "LastUpdateDate": "09/08/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "051339",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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