Active NPI
Nurse Practitioner in Adult Gerontology Family and Pallative
- Adult Health Nurse Practitioner
- Bronx, NY
National Provider Identifier
1376124297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- Legal business name
- NURSE PRACTITIONER IN ADULT GERONTOLOGY FAMILY AND PALLATIVE
- Practice address
- 100 West Kindsbridge Road
Bronx, NY 10468-0355 - Phone
- (917) 915-2866
- NPI assigned
- Apr 21, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Josephine Zetilia Gabriel, NP
- Title
- Member
- Phone
- (917) 915-2866
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | Primary |
Addresses
Primary practice location
100 West Kindsbridge Road
Bronx, NY 10468-0355
Mailing address
169 S Main St
New City, NY 10956-3353
Phone (917) 915-2866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356367569 | Medicaid | NY |
National Provider Directory
National Provider Directory- Tax ID family
- Nurse Practitioner in Adult Gerontology Family and Pallative
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nursing Care Agency
- New City, NY
- NPI 1720659634
Locations
169 S Main St
New City, NY 10956
Phone (917) 324-8860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618963200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618963200000",
"number": "1376124297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 S MAIN ST",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109563353",
"telephone_number": "917-915-2866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WEST KINDSBRIDGE ROAD",
"city": "BRONX",
"state": "NY",
"postal_code": "104680355",
"telephone_number": "917-915-2866"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NURSE PRACTITIONER IN ADULT GERONTOLOGY FAMILY AND PALLATIVE",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-21",
"last_updated": "2021-04-21",
"certification_date": "2021-03-26",
"status": "A",
"authorized_official_last_name": "GABRIEL",
"authorized_official_first_name": "JOSEPHINE",
"authorized_official_middle_name": "ZETILIA",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "917-915-2866",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1356367569",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.