Diana Grullon Tavares

Primary specialty

PharmacistTaxonomy code 183500000X

License

035341 Issued in NY

Practice address

2240 3Rd Ave
New York, NY 10035-2904

Phone

(212) 360-1757

Fax

(917) 675-7055

NPI assigned

Mar 16, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Harlem Corner Pharmacy Inc

  • Community/Retail Pharmacy
  • New York, NY
  • NPI 1689115198
  NPD
• Nypres Pharmacy Inc

  • Community/Retail Pharmacy
  • New York, NY
  • NPI 1619335593
  NPD

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1154862654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352904",
            "telephone_number": "212-360-1757",
            "fax_number": "917-675-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352904",
            "telephone_number": "212-360-1757",
            "fax_number": "917-675-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULLON TAVARES",
        "first_name": "DIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "035341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Gruenstein, M.D.
• Kirsten Mary Grueter
• Lauren Brooke Gruffi, MD
• Thomas Robert Gruffi, M.D.
• Matthew John Grujich, MD
• Clarissa Antonia Grullon, BA, MA
• Genesis Grullon, RN, NP
• Gissel Grullon, OTR/L
• Lianne Grullon, LMSW
• Willie Grullon

• Pharmacist in New York, NY
• Providers in New York, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.