Penina Esther Gourdji, BCBA, LBA NYS

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

002149 Issued in NY

Practice address

341 Trinity PL
Malverne, NY 11565-1234

Phone

(516) 229-1194

NPI assigned

Aug 26, 2021

Last updated

Aug 26, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1386311306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 FAIRLAWN AVE",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115522106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 TRINITY PL",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651234",
            "telephone_number": "516-229-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURDJI",
        "first_name": "PENINA",
        "middle_name": "ESTHER",
        "name_prefix": "Mrs.",
        "credential": "BCBA, LBA NYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "002149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nailah Estelle Gabriel
• Peter T. Gambino, PH.D.
• Christina Marie Giardina
• Mary Ann Glick, NP
• Daniella E Goldenstein, BCBA
• Karen Sue Greenfield, PT
• Kimberly Greenidge, BCBA, LBA
• Anna Maria Guadagnoli, M.S.
• Susan Elizabeth Halley
• Jong Sik Han, L.AC.

• Behavior Analyst in Malverne, NY
• Providers in Malverne, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.