MICHELINE BOULIS (NPI# 1609241942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609241942 |
| Entity Type | Individual |
| Full Name | MICHELINE BOULIS |
| Practice Address |
5 Croft Pl Staten Island NY 10314-6501 |
| Practice Telephone | 7183540957 |
| Mailing Telephone | 7183540957 |
| Enumeration Date | 2015-12-12 |
| Last Update Date | 2015-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 28RI03755500 | NJ | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 061238 | NY | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | PHARMACIST LICENSE NUMBER | 28RI03755500 | 01 |
| NY | PHARMACIST LICENSE NUMBER | 061238 | 01 |
| Street Address |
5 CROFT PL |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-6501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220370 | Minamark M Nageib | Pharmacist | 72 Bridgetown St, Staten Island, NY 10314-6204 | 2020-09-22 |
| 1912513805 | Zakaria Amin | Pharmacist | 382 Ridgewood Ave, Staten Island, NY 10312-2118 | 2020-09-17 |
| 1073136065 | Matthew Thomas Tilatitsky | Pharmacist | 103 Sprague Ave, Staten Island, NY 10307-1931 | 2020-05-25 |
| 1255967220 | Peter J Delorenzo | Pharmacist | 123 Oxford Pl, Staten Island, NY 10301-3016 | 2020-03-21 |
| 1710525514 | Ira Bace | Pharmacist | 146 Freedom Ave, Staten Island, NY 10314-3706 | 2019-12-12 |
| 1760026983 | Hassan Gihad Hamouche | Pharmacist | 213 Norway Ave, Staten Island, NY 10305-3522 | 2019-10-30 |
| 1730722448 | Daniel Nabil Girgis | Pharmacist | 177 Sandalwood Dr, Staten Island, NY 10308-1863 | 2019-10-25 |
| 1437714300 | Miriam Lyubina | Pharmacist | 29 Star Ct, Staten Island, NY 10312-2448 | 2019-05-07 |
| 1134686173 | Muhammad Usman | Pharmacist | 928 Rockland Ave Apt 2, Staten Island, NY 10314-7706 | 2019-02-26 |
| 1831660786 | Amir I Yaqoob | Pharmacist | 92 Slater Blvd, Staten Island, NY 10305-2106 | 2018-12-17 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on MICHELINE BOULIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.