Organization Active NPI

GB RN PC

Doing business as Aeon Aesthetics & Gynecology

  • Obstetrics & Gynecology Physician
  • Huntington Station, NY
National Provider Identifier
1366036782
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
GB RN PC
Doing business as
Aeon Aesthetics & Gynecology
Aeon Aesthetics Gynecology
Practice address
33 Walt Whitman Rd Ste 232
Huntington Station, NY 11746-4293
Phone
(631) 923-3001
Fax
(631) 923-1052
NPI assigned
Feb 25, 2021
Last updated
Feb 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Galo Burbano, RNNPI 1285654715
Title
Owner
Phone
(631) 923-3001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

33 Walt Whitman Rd Ste 232
Huntington Station, NY 11746-4293

Mailing address

33 Walt Whitman Rd Ste 232
Huntington Station, NY 11746-4293
Phone (631) 923-3001

Other names 2

  • Aeon Aesthetics & Gynecology Doing business as
  • Aeon Aesthetics Gynecology Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1366036782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WALT WHITMAN RD STE 232",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117464293",
            "telephone_number": "631-923-3001",
            "fax_number": "631-923-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WALT WHITMAN RD STE 232",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117464293",
            "telephone_number": "631-923-3001",
            "fax_number": "631-923-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GB RN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "BURBANO",
        "authorized_official_first_name": "GALO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-923-3001",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aeon Aesthetics & Gynecology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aeon Aesthetics Gynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.