Lara Jane Gongob Sardea, BSN,RN,MSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

824423 Issued in NY

Practice address

5423 83Rd St
Elmhurst, NY 11373-4723

Phone

(332) 234-2256

NPI assigned

Oct 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lara Jane Jordas Gongob Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1073277109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5423 83RD ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5423 83RD ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734723",
            "telephone_number": "332-234-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARDEA",
        "first_name": "LARA JANE",
        "middle_name": "GONGOB",
        "credential": "BSN,RN,MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "824423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA JANE",
            "last_name": "GONGOB",
            "middle_name": "JORDAS",
            "credential": "BSN,RN,MSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura A Santos, MD
• Mugdha Santra, M.D
• Karol Elizabeth Saquinaula Perez
• Lisa Saraydarian, PSYD
• Jennifer Sarcone, LCSW
• Jennet Mercado Sarmiento, PT
• Michelle Sarzaba
• Jason Sarzosa
• Terence Sasaki, M.D.
• Quazi Zafri Satter, DDS

• Registered Nurse in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.