Individual provider Active NPI

Diana Marie Gerbauckas, R.PH.,MS

  • Pharmacist
  • New York, NY
National Provider Identifier
1376690545
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
025194-1 Issued in NY
Practice address
1569 1St Ave
New York, NY 10028-4003
Phone
(212) 249-5198
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 025194-1 NY Primary

Addresses

Primary practice location

1569 1St Ave
New York, NY 10028-4003

Mailing address

330 E 80TH St
Apt 6 H
New York, NY 10021-0915
Phone (212) 988-7379

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
Master of Science, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
025194-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC Past Accepting new patients
CVS Albany LLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376690545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E 80TH ST",
            "address_2": "APT 6 H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210915",
            "telephone_number": "212-988-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100284003",
            "telephone_number": "212-249-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERBAUCKAS",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "R.PH.,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "025194-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.