GLORIA PAK (NPI# 1659891042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659891042 |
| Entity Type | Individual |
| Full Name | GLORIA PAK |
| Credential | CPNP |
| Practice Address |
1065 Southern Blvd Bronx NY 10459-2417 |
| Practice Telephone | 7185892440 |
| Mailing Telephone | 7185892440 |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2018-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 713794 | NY | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
382836 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790068930 | Gloria J Pak | Pharmacist | 2151 Lemoine Ave, Fort Lee, NJ 07024-6041 | 2011-09-23 |
| Street Address |
1065 SOUTHERN BLVD |
| City | BRONX |
| State | NY |
| Zip Code | 10459-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609872035 | Claude Parola | Internal Medicine | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2005-06-21 |
| 1386243582 | Maribel Luna Cruz | Radiologic Technologist | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-10-20 |
| 1669080685 | Anna Katrina Reyes Florendo | Nurse Practitioner | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-07-15 |
| 1588280911 | Daniel James Mulcahy | Physician Assistant | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-06-22 |
| 1629691142 | Kelly K Smith | Nurse Practitioner | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-05-19 |
| 1740813856 | Oresta Victoria Borodevyc | Physician Assistant | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-02-17 |
| 1891327557 | Temina A Kusi | Physician Assistant | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2020-02-10 |
| 1780220590 | Maria Feliz | Social Worker | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2019-11-27 |
| 1104460237 | Josiah Guitian | Physician Assistant | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2019-11-01 |
| 1508400938 | Nayary Santana | Social Worker | 1065 Southern Blvd, Bronx, NY 10459-2417 | 2019-10-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508458 | Sterling Smiles LLC | Dentist | 1022 E163rd St, Bronx, NY 10459 | 2020-11-02 |
| 1710496633 | Vitus C. Ezerioha | Licensed Practical Nurse | 870 Southern Blvd., Apt 1a, Bronx, NY 10459 | 2017-09-22 |
| 1790208403 | Jessica S Lee | Early Intervention Provider Agency | 985 Intervale Ave Apt. 2c, Bronx, NY 10459 | 2017-07-25 |
| 1669901070 | Ruthlyn Merrick | Registered Nurse | 1466 Louis Nine Blvd, Bronx, NY 10459 | 2017-06-08 |
| 1154865681 | John Wahl | Speech-Language Pathologist | 977 Fox St., Is 217, Bronx, NY 10459 | 2016-12-19 |
| 1801349675 | Aneesa Ible | Social Worker | 953 Southern Blvd, Suite 301, Odyssey House Inc., Bronx, NY 10459 | 2016-07-28 |
| 1457711277 | Agboade Ademiju | Registered Nurse | 900 Intervale Ave, Archcare, Bronx, Bronx, NY 10459 | 2016-03-07 |
| 1952760076 | Apollo Radio Dispatcher | Taxi | 801 Freeman Street, Bronx, NY 10459 | 2016-02-17 |
| 1730547522 | Foxhurst Medical of New York LLC | Surgery | 947 Southern Blvd Ste B, Bronx, NY 10459 | 2016-02-08 |
| 1063892388 | Vismar Radio Dispatch Inc. | Taxi | 1040-52 Freeman St, Bronx, NY 10459 | 2015-06-02 |
| Find all providers in zip 10459 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871145300 | Kaliko Saroj Sharma | Nurse Practitioner | 2805 Heath Ave, Bronx, NY 10463-7805 | 2019-07-15 |
| 1699180596 | Abigail Felix | Nurse Practitioner | 3032 Corlear Ave Fl 1, Bronx, NY 10463-5141 | 2014-06-30 |
| 1609157007 | Evelyn A O'neill-brown | Nurse Practitioner | 3011 Randall Ave, Bronx, NY 10465-2359 | 2011-08-30 |
| 1891000501 | Deepa Manohara | Nurse Practitioner | 705 E 180th St, Bronx, NY 10457-3601 | 2010-08-18 |
| 1245544360 | Richard Joseph Beaulieu | Nurse Practitioner | 1515 Souther Boulevard, Bronx, NY 10460 | 2010-07-30 |
| 1477793511 | Linda Anne Reid | Nurse Practitioner | 369 E 149th Street, 3rd Floor, Bronx, NY 10455 | 2009-03-03 |
| 1861642415 | Olga Mae Manns | Nurse Practitioner | 85 West Burnside Avenue, Bronx, NY 10453-4015 | 2008-09-19 |
| 1407024839 | Dora Alejandra Acevedo | Nurse Practitioner | 275 Balcom Ave, Bronx, NY 10465-3104 | 2008-02-19 |
| 1881721975 | Regina A Whitlow | Nurse Practitioner | 112 East 210th Street, Mmc - School Health Program, Bronx, NY 10467 | 2007-02-27 |
| 1457492027 | Teresa Ann Wilson | Nurse Practitioner | 3961 Hillman Ave, Montefiore School Health Clinic, Bronx, NY 10463-3001 | 2007-02-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.