Active NPI
Gloria Rafanelli-Werthner
- Specialist
- Plainview, NY
National Provider Identifier
1760164016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2569752
- Practice address
- 255 Executive Dr Ste Ll105
Plainview, NY 11803-1718 - Phone
- (516) 576-2040
- NPI assigned
- Aug 7, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2569752 | NY | Primary |
Addresses
Primary practice location
255 Executive Dr Ste Ll105
Plainview, NY 11803-1718
Mailing address
112 Eatons Neck Rd
Northport, NY 11768-1110
Phone (631) 624-4073
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2569752 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1760164016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 EATONS NECK RD",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "117681110",
"telephone_number": "631-624-4073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 EXECUTIVE DR STE LL105",
"city": "PLAINVIEW",
"state": "NY",
"postal_code": "118031718",
"telephone_number": "516-576-2040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFANELLI-WERTHNER",
"first_name": "GLORIA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-07",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "2569752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainview, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.