Crystal Hrubiak

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

294758-1 Issued in NY

Practice address

6779 Black Rd
Derby, NY 14047-9710

Phone

(716) 951-6011

NPI assigned

May 25, 2015

Last updated

May 25, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1432512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432512000000",
    "number": "1629457510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6779 BLACK RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479710",
            "telephone_number": "716-951-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6779 BLACK RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479710",
            "telephone_number": "716-951-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRUBIAK",
        "first_name": "CRYSTAL",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-25",
        "last_updated": "2015-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "294758-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Derby, NY
• Providers in Derby, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2015; 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.