Individual provider Active NPI

Priscilla K Gavin, RPH

  • Pharmacist
  • Queensbury, NY
National Provider Identifier
1578740973
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0424551 Issued in NY
Practice address
216 Quaker Rd
Queensbury, NY 12804
Phone
(518) 793-1881
Fax
(518) 793-0162
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 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 0424551 NY Primary

Addresses

Primary practice location

216 Quaker Rd
Queensbury, NY 12804

Mailing address

216 Quaker Rd
Queensbury, NY 12804-1778
Phone (518) 793-1881

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
0424551NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC Past Accepting new patients
CVS Albany, L.L.C. 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": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1578740973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 QUAKER RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041778",
            "telephone_number": "518-793-1881",
            "fax_number": "518-793-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 QUAKER RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "12804",
            "telephone_number": "518-793-1881",
            "fax_number": "518-793-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "PRISCILLA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "0424551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.