Active NPI
Peter Paul Gorgoglione, RN
- Registered Nurse
- Staten Island, NY
National Provider Identifier
1609324482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 684691-1
- Practice address
- 77 Chicago Ave
Staten Island, NY 10305-3757 - Phone
- (718) 442-7828
- Fax
- (718) 720-0762
- NPI assigned
- Sep 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 684691-1 | NY | |
| Social Worker | 104100000X | 684691-1 | NY | |
| Registered Nurse | 163W00000X | 684691-1 | NY | Primary |
Addresses
Primary practice location
77 Chicago Ave
Staten Island, NY 10305-3757
Mailing address
77 Chicago Avenue
Staten Island, NY 10305
Phone (718) 442-7828
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 684691-1 | NY | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1609324482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 CHICAGO AVENUE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10305",
"telephone_number": "718-442-7828",
"fax_number": "718-720-0762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 CHICAGO AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053757",
"telephone_number": "718-442-7828",
"fax_number": "718-720-0762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORGOGLIONE",
"first_name": "PETER",
"middle_name": "PAUL",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-21",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "684691-1",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "684691-1",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "684691-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.