Individual provider Active NPI

Roberta Geraldine Buriak, RN

  • Home Health Registered Nurse
  • New London, CT
National Provider Identifier
1093869117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
R48605 Issued in CT
Practice address
225 State St
Suite 103
New London, CT 06320-6357
Phone
(860) 443-7222
Fax
(860) 437-3498
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X R48605 CT Primary

Addresses

Primary practice location

225 State St
Suite 103
New London, CT 06320-6357

Mailing address

8 N Glenwoods Rd
Gales Ferry, CT 06335-1013
Phone (860) 464-6458

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R48605CTMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093869117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 N GLENWOODS RD",
            "city": "GALES FERRY",
            "state": "CT",
            "postal_code": "063351013",
            "telephone_number": "860-464-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 STATE ST",
            "address_2": "SUITE 103",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206357",
            "telephone_number": "860-443-7222",
            "fax_number": "860-437-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURIAK",
        "first_name": "ROBERTA",
        "middle_name": "GERALDINE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CT",
            "license": "R48605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

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.

Verify at the official NPI Registry.