Active NPI
Gwendoline Frances Yvonne Lanza, MD
- Psychiatry Physician
- Hyde Park, NY
National Provider Identifier
1679504278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 037685
- Practice address
- 4236 Albany Post Rd
Hyde Park, NY 12538 - Phone
- (845) 229-2196
- Fax
- (845) 229-1650
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 121559 | CT | |
| Psychiatry Physician | 2084P0800X | 037685 | NY | Primary |
Addresses
Primary practice location
4236 Albany Post Rd
Hyde Park, NY 12538
Mailing address
20 Val-Kill Drive
Poughkeepsie, NY 12601
Phone (845) 471-8030
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0045805 | Other | NY | VALUE OPTIONS GHI EMPIRE |
| 207234 | Other | NY | MVP |
| 12396652 | Other | MULTIPLAN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121559 | CT | MD | Psychiatry Physician |
| 037685 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679504278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 VAL-KILL DRIVE",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "12601",
"telephone_number": "845-471-8030",
"fax_number": "845-229-1650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4236 ALBANY POST RD",
"city": "HYDE PARK",
"state": "NY",
"postal_code": "12538",
"telephone_number": "845-229-2196",
"fax_number": "845-229-1650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANZA",
"first_name": "GWENDOLINE",
"middle_name": "FRANCES YVONNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "121559",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "037685",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS GHI EMPIRE",
"identifier": "0045805",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "207234",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "12396652",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.