Active NPI
Jill Marie Gonzalo, BSPH
- Pharmacist
- Conshohocken, PA
National Provider Identifier
1013063254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP-095368L
- Practice address
- 200 W Ridge Pike
200 Ridge Pike
Conshohocken, PA 19428-3702 - Phone
- (610) 276-1000
- Fax
- (610) 276-1004
- NPI assigned
- Jan 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | RP-095368L | PA | Primary |
Addresses
Primary practice location
200 W Ridge Pike
200 Ridge Pike
Conshohocken, PA 19428-3702
Mailing address
101 Moir Ave
West Conshohocken, PA 19428-2843
Phone (610) 828-4120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP-095368L | Other | PA | PHARMACY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP-095368L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013063254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 MOIR AVE",
"city": "WEST CONSHOHOCKEN",
"state": "PA",
"postal_code": "194282843",
"telephone_number": "610-828-4120",
"fax_number": "610-828-4120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W RIDGE PIKE",
"address_2": "200 RIDGE PIKE",
"city": "CONSHOHOCKEN",
"state": "PA",
"postal_code": "194283702",
"telephone_number": "610-276-1000",
"fax_number": "610-276-1004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALO",
"first_name": "JILL",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "BSPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP-095368L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "RP-095368L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conshohocken, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.