Individual provider Active NPI

Mary K Gonyea

  • Pharmacist
  • Ithaca, NY
National Provider Identifier
1255926879
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
037527 Issued in NY
Practice address
110 Ho PLZ
Ithaca, NY 14853-3102
Phone
(607) 255-6976
NPI assigned
Mar 5, 2021
Last updated
Mar 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 037527 NY Primary

Addresses

Primary practice location

110 Ho PLZ
Ithaca, NY 14853-3102

Mailing address

110 Ho PLZ
Ithaca, NY 14853-3102

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

State licenses

LicenseStateTypeSpecialty
037527NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell University PastSince Mar 7, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1255926879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HO PLZ",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HO PLZ",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533102",
            "telephone_number": "607-255-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONYEA",
        "first_name": "MARY",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "037527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.