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NPI Code Detail

MEDICARE: MICHAEL LYRISTIS

MEDICARE: MICHAEL LYRISTIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist053855NY

General Provider Information

NPI Number : 1942537576
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL LYRISTIS
Provider Business Mailing Address
First Line : 1749 1ST AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10128-5202
Country : US
Telephone Number : 646-672-1760
Fax Number : 646-672-1765
Provider Business Practice Location Address
First Line : 1749 1ST AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10128-5202
Country : US
Telephone Number : 646-672-1760
Fax Number : 646-672-1765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2009
Last Update Date : 11/03/2009

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Directions to “ MICHAEL LYRISTIS ” Practice Location

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