Active NPI
Gratia C Deane, R.PH.,M.S.
- Pharmacist
- Rensselaer, NY
National Provider Identifier
1104008440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 35046
- Practice address
- 279 Troy Rd
Rensselaer, NY 12144-9499 - Phone
- (518) 283-3021
- Fax
- (518) 283-3031
- NPI assigned
- Nov 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 35046 | NY | Primary |
| Pharmacist | 183500000X | 17539 | MA |
Addresses
Primary practice location
279 Troy Rd
Rensselaer, NY 12144-9499
Mailing address
279 Troy Rd
Rensselaer, NY 12144-9499
Phone (518) 283-3021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01394852 | Medicaid | NY |
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
- Master of Science, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17539 | MA | MD | Pharmacist |
| 35046 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1104008440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "279 TROY RD",
"city": "RENSSELAER",
"state": "NY",
"postal_code": "121449499",
"telephone_number": "518-283-3021",
"fax_number": "518-283-3031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "279 TROY RD",
"city": "RENSSELAER",
"state": "NY",
"postal_code": "121449499",
"telephone_number": "518-283-3021",
"fax_number": "518-283-3031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEANE",
"first_name": "GRATIA",
"middle_name": "C",
"credential": "R.PH.,M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-28",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "35046",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "17539",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01394852",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rensselaer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.