Individual provider Active NPI

Gary Lynn Lansburg Sr., R.PH.

  • Pharmacist
  • Hudson, NY
National Provider Identifier
1417135492
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
035459-1 Issued in NY
Practice address
173 Fairview Ave
Hudson, NY 12534-1205
Phone
(518) 828-4341
NPI assigned
Feb 1, 2008
Last updated
Mar 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 035459-1 NY Primary

Addresses

Primary practice location

173 Fairview Ave
Hudson, NY 12534-1205

Mailing address

23 Van Buren Ave
Castleton, NY 12033-1316
Phone (518) 732-2131

Other identifiers 1

IdentifierTypeStateIssuer
00035459MedicaidNY

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
035459-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1417135492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 VAN BUREN AVE",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "120331316",
            "telephone_number": "518-732-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 FAIRVIEW AVE",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125341205",
            "telephone_number": "518-828-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANSBURG",
        "first_name": "GARY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "035459-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00035459",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.