Individual provider Active NPI

Gabriella Desiree Doumazios

  • Registered Nurse
  • Hauppauge, NY
National Provider Identifier
1386350288
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
737096 Issued in NY
Practice address
80 Arkay Dr Ste 230
Hauppauge, NY 11788-3705
Phone
(917) 730-3368
NPI assigned
Jan 25, 2023
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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 737096 NY Primary

Addresses

Primary practice location

80 Arkay Dr Ste 230
Hauppauge, NY 11788-3705

Mailing address

89 Hidden Ponds Cir
Smithtown, NY 11787-5227
Phone (516) 761-0492

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
737096NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1386350288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 HIDDEN PONDS CIR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875227",
            "telephone_number": "516-761-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ARKAY DR STE 230",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883705",
            "telephone_number": "917-730-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUMAZIOS",
        "first_name": "GABRIELLA",
        "middle_name": "DESIREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "737096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.