Individual provider Active NPI

Olimpia Gambacorta, LPN

  • Licensed Practical Nurse
  • White Plains, NY
National Provider Identifier
1801054432
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2375411 Issued in NY
Practice address
16 Freedom Rd
White Plains, NY 10603-2531
Phone
(914) 328-3157
NPI assigned
May 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2375411 NY Primary

Addresses

Primary practice location

16 Freedom Rd
White Plains, NY 10603-2531

Mailing address

16 Freedom Rd
White Plains, NY 10603-2531
Phone (914) 328-3157

Other identifiers 1

IdentifierTypeStateIssuer
02043814MedicaidNY

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

LicenseStateTypeSpecialty
2375411NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1801054432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FREEDOM RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106032531",
            "telephone_number": "914-328-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 FREEDOM RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106032531",
            "telephone_number": "914-328-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBACORTA",
        "first_name": "OLIMPIA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2375411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02043814",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.