Individual provider Active NPI

Maryann Gambino

  • Registered Nurse
  • Miller Place, NY
National Provider Identifier
1376846493
Registry record updated Dec 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
395349-1 Issued in NY
Practice address
270 Radio Ave
Miller Place, NY 11764-3526
Phone
(631) 849-3617
Fax
(631) 849-3617
NPI assigned
Dec 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 395349-1 NY Primary

Addresses

Primary practice location

270 Radio Ave
Miller Place, NY 11764-3526

Mailing address

270 Radio Ave
Miller Place, NY 11764-3526
Phone (631) 849-3617

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
395349-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1292025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292025600000",
    "number": "1376846493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 RADIO AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117643526",
            "telephone_number": "631-849-3617",
            "fax_number": "631-849-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 RADIO AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117643526",
            "telephone_number": "631-849-3617",
            "fax_number": "631-849-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBINO",
        "first_name": "MARYANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-11",
        "last_updated": "2010-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "395349-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2010; 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.