Gayle M Tanenbaum, BS, RPH

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RPH022160 Issued in GA

Practice address

1401 Bulloch Lake CT
Loganville, GA 30052-8649

Phone

(770) 554-1429

Fax

(770) 544-0929

NPI assigned

Jan 21, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Registered Pharmacist

State licenses

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1215326707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 BULLOCH LAKE CT",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528649",
            "telephone_number": "770-554-1429",
            "fax_number": "770-544-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BULLOCH LAKE CT",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528649",
            "telephone_number": "770-554-1429",
            "fax_number": "770-544-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANENBAUM",
        "first_name": "GAYLE",
        "middle_name": "M",
        "credential": "BS, RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH022160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "RPH022160",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hasan Ali Syed, D.M.D.
• Saima Syed, MD
• Adrian Penny Sykes, PHARM.D.
• T and D Home Care Inc.
• Akhila Takkallapalli
• Stephanie Mary Tarracciano, D.O.
• Kelsey Tatum
• Sanjeev S Tendolkar, M.D.
• Ashley Thao
• The Cocoon

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Loganville, GA
• Providers in Loganville, GA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.