Active NPI
Lisa Gandolfo
- School Registered Nurse
- Brooklyn, NY
National Provider Identifier
1124562277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 387742-1
- Practice address
- 1139 Coney Island Ave
Brooklyn, NY 11230-2305 - Phone
- (718) 724-1730
- Fax
- (718) 724-1735
- NPI assigned
- Dec 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 387742-1 | LA | Primary |
Addresses
Primary practice location
1139 Coney Island Ave
Brooklyn, NY 11230-2305
Mailing address
1139 Coney Island Ave
Brooklyn, NY 11230-2305
Phone (718) 724-1730
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
| License | State | Type | Specialty |
|---|---|---|---|
| 387742-1 | LA | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481155200000",
"number": "1124562277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1139 CONEY ISLAND AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112302305",
"telephone_number": "718-724-1730",
"fax_number": "718-724-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1139 CONEY ISLAND AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112302305",
"telephone_number": "718-724-1730",
"fax_number": "718-724-1735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANDOLFO",
"first_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-08",
"last_updated": "2016-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "LA",
"license": "387742-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.