Gordana Obradovic, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

277267 Issued in NY

Practice address

1304 Buckley Rd
Suite 200
Syracuse, NY 13212-4311

Phone

(315) 478-3311

Fax

(315) 476-5211

NPI assigned

Jun 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1013176403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602",
            "address_2": "SUITE 200",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134130602",
            "telephone_number": "315-624-9000",
            "fax_number": "315-624-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 BUCKLEY RD",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124311",
            "telephone_number": "315-478-3311",
            "fax_number": "315-476-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRADOVIC",
        "first_name": "GORDANA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT191225",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "277267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anis I Obeid, MD FACC
• Mohamad Jamal Eddine Obeid, MD
• Laura Oberlander, MSW
• Supriya Oberoi, MD
• Mauricio Obon Dent, M.D.
• Karen L Obrien-Mazza, LPN
• Abigail Obrist, OTR
• Erika Obrist, NP
• Laurie Anne Obrist, MS, CCC-SLP
• Sara Marie Obrist, LMSW, MFT

• Nephrology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.