Larissa Gourdet, A.N.P

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F307969 Issued in NY

Practice address

997 Glen Cove Ave
Glen Head, NY 11545-1593

Phone

(516) 674-9144

NPI assigned

Oct 6, 2016

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1497205173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 GLEN COVE AVE",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451593",
            "telephone_number": "516-674-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 GLEN COVE AVE",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451593",
            "telephone_number": "516-674-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURDET",
        "first_name": "LARISSA",
        "credential": "A.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pamela Gordon, OT
• Onoufrios Goussis, M.D.
• Elaine Greenberg, PT
• Michael I Gurevich, M.D.
• Nina Gurevich, MD
• Ghazanfar W Haidery, MD

• All providers in Glen Head, NY
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.