Active NPI
Kourtnei-Rae Lorraine Gondeck, PHARMD
- Pharmacist
- Syracuse, NY
National Provider Identifier
1154979102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 065781
- Practice address
- 6040 Tarbell Rd Ste 103
Syracuse, NY 13206-1348 - Phone
- (888) 843-2040
- Fax
- (888) 842-3977
- NPI assigned
- Sep 3, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 065781 | NY | Primary |
Addresses
Primary practice location
6040 Tarbell Rd Ste 103
Syracuse, NY 13206-1348
Mailing address
6040 Tarbell Rd Ste 103
Syracuse, NY 13206-1348
Phone (888) 843-2040
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 065781 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567468800000",
"number": "1154979102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6040 TARBELL RD STE 103",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132061348",
"telephone_number": "888-843-2040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6040 TARBELL RD STE 103",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132061348",
"telephone_number": "888-843-2040",
"fax_number": "888-842-3977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONDECK",
"first_name": "KOURTNEI-RAE",
"middle_name": "LORRAINE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-03",
"last_updated": "2019-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "065781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.