Teresa G Gambardella, RPH
Individual provider Active NPI Pharmacist · Greenlawn, NY
NPI 1447423694 · NPPES record last updated Apr 9, 2008
Key facts
- NPI
- 1447423694
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0044510 (NY)
- Practice address
- 20 Wells Rd
Greenlawn, NY 11740-1506 - Phone
- (631) 368-4098
- Fax
- (631) 261-6371
- NPI assigned
- Apr 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0044510 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0044510 | NY | Yes |
Addresses
Primary practice location
20 Wells Rd
Greenlawn, NY 11740-1506
Mailing address
20 Wells Rd
Greenlawn, NY 11740-1506
Phone (631) 368-4098
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18350000X | Medicaid | NY |
Other providers in Greenlawn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.