MRS. LORI GONZALO (NPI# 1639294002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639294002 |
| Entity Type | Individual |
| Full Name | MRS. LORI GONZALO |
| Credential | RPA-C |
| Practice Address |
2071 Clove Rd Grasmere Medical Pavillion Staten Island NY 10304-1671 |
| Mailing Address |
20 Emily Ct Staten Island NY 10307-2087 |
| Practice Telephone | 7184425550 |
| Practice Fax Number | 7185563025 |
| Mailing Telephone | 7189661784 |
| Mailing Fax Number | 7189661969 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2009-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
009282 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2071 CLOVE RD GRASMERE MEDICAL PAVILLION |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10304-1671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245202555 | Jay B. Basillote | Specialist | 2071 Clove Rd, Suite J, Staten Island, NY 10304-1612 | 2006-02-02 |
| 1326302803 | Staten Island Medical Group, Pllc | Clinic/Center | 2071 Clove Rd, Staten Island, NY 10304-1612 | 2012-06-28 |
| 1093019333 | Grasmere Sleep Lab Corp | Internal Medicine | 2071 Clove Rd, Staten Island, NY 10304-1671 | 2010-12-30 |
| 1942503750 | Richmond Imaging Corp | Radiology | 2071 Clove Rd, Staten Island, NY 10304-1671 | 2010-12-16 |
| 1366745374 | Richmond Imaging Corp | Radiology | 2071 Clove Rd, Staten Island, NY 10304-1671 | 2010-12-13 |
| 1083926976 | Kevin H Weiner, Md, PC | Specialist | 2071 Clove Rd, Staten Island, NY 10304-1671 | 2010-07-08 |
| 1609095884 | Charles Demarco | Orthopaedic Surgery | 2071 Clove Rd, Staten Island, NY 10304-1671 | 2007-04-25 |
| 1285775908 | Bg Medical and Diagnostic PC | Internal Medicine | 2071 Clove Rd, Staten Island, NY 10304-1671 | 2007-02-08 |
| 1851454862 | Lynda Baron | Nurse Practitioner | 2071 Clove Rd, Staten Island, NY 10304-1612 | 2006-12-19 |
| 1205939998 | Richard Maggio | Specialist | 2071 Clove Rd, Suite J, Staten Island, NY 10304-1612 | 2006-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215542923 | Margaret Chifong Tam | Nurse Practitioner | 85 Venice Avenue, Staten Island, NY 10304 | 2020-09-10 |
| 1598397788 | Alexandria & Akea's Playhouse, Inc. | Day Training, Developmentally Disabled Services | 1864 Clove Road, Staten Island, NY 10304 | 2020-02-06 |
| 1548746811 | Bryant Edward Pearson | Technician/Technologist | 664 Bay Street, Staten Island, NY 10304 | 2018-07-19 |
| 1366941668 | Safwat Attia Youssef | Orthopaedic Surgery | 25 Sunrise Terrace, Staten Island, New York, NY 10304 | 2018-02-02 |
| 1699294090 | Kate Lynn Chimienti | Specialist/Technologist | 52 Smith Ter Fl1, Staten Island, NY 10304 | 2017-09-17 |
| 1881117315 | Fun Speech Therapy, P.C. | Early Intervention Provider Agency | 367 St Pauls Ave., Staten Island, NY 10304 | 2017-07-17 |
| 1720517097 | Senada Pelinkovic | Speech-Language Pathologist | 29 Remsen St, Staten Island, NY 10304 | 2017-06-08 |
| 1760927255 | Kpannah Moore | Licensed Practical Nurse | 492 Vanderbilt Avenue, Staten Island, NY 10304 | 2016-12-20 |
| 1689116592 | Rena Li | Registered Nurse | 30 Celebration Lane, Staten Island, NY 10304 | 2016-11-09 |
| 1407304835 | Esther Mitnick | Counselor | 285 Vanderbilt Avenue, State Island, NY 10304 | 2016-09-14 |
| Find all providers in zip 10304 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457985517 | Fina Vitale | Physician Assistant | 61 Littlefield Ave, Staten Island, NY 10312-6509 | 2020-02-27 |
| 1154709210 | Diana Deluca | Physician Assistant | 55 Johanna Ln, Staten Island, NY 10309-3632 | 2015-05-09 |
| 1881081784 | Aminata Dieng | Physician Assistant | 141 Parkhill Av Apt 4w, Staten Island, NY 10304-3402 | 2015-04-20 |
| 1134517071 | Michael Migliorini | Physician Assistant | 416 Mcclean Ave, Staten Island, NY 10305-3610 | 2014-12-30 |
| 1629353180 | Anna Litvin | Physician Assistant | 3913 Richmond Ave., Staten Island, NY 10312 | 2011-10-17 |
| 1487942645 | Rachel Tova Steinberg | Physician Assistant | 1012 Westwood Ave, Staten Island, NY 10314-4242 | 2011-07-20 |
| 1245539949 | Austin Epstein | Physician Assistant | 305 Seguine Ave Apt 1, Staten Island, NY 10309-3712 | 2011-03-21 |
| 1275843807 | Marlena Ludwika Burek | Physician Assistant | 23 Laforge Ave, 2, Staten Island, NY 10302-1634 | 2010-10-17 |
| 1811207962 | Marie Nicole Caragiulo | Physician Assistant | 176 Lovelace Ave, Staten Island, NY 10312-3208 | 2010-10-07 |
| 1831421999 | Krishma Patel | Physician Assistant | 45 Little Clove Rd, Staten Island, NY 10301-4306 | 2010-01-31 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10304 |
Please comment or provide details below to improve the information on MRS. LORI GONZALO.
| 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.