Miriam Gordon Pediatric NP PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

Legal business name

MIRIAM GORDON PEDIATRIC NP PC

Practice address

7 Ismay Street
Staten Island, NY 10314

Phone

(718) 815-1000

Fax

(718) 815-1000

NPI assigned

Jan 30, 2019

Organization subpart

No

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

Authorized official

Name

Miriam Blau, NPNPI 1780884205

Title

Ceo

Phone

(718) 815-8122

Specialties & licenses 1

Addresses

Tax ID family

Miriam Gordon Pediatric NP PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Miriam Gordon Pediatric NP PC

  • Pediatric Nurse Practitioner
  • Brooklyn, NY
  • NPI 1306233408
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miriam S Blau, R.N., P.N.P.

  • Pediatric Nurse Practitioner
  • Staten Island, NY
  • NPI 1780884205

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1750845137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ISMAY STREET",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-815-1000",
            "fax_number": "718-815-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ISMAY STREET",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-815-1000",
            "fax_number": "718-815-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRIAM GORDON PEDIATRIC NP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "BLAU",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-815-8122",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janeen Miraglia, DO
• Julianne Miranda
• Luis Da Graca Miranda, MD
• Marjorie G Miranda
• Janna Mirazita, LMSW
• Miriam Rozenberg Et Al Lily Pond Nursing Home
• Brian F Mirman, DMD
• Boris Mirochnik
• Leo Mirochnik, PTA
• Alena Mironova, LMSW

• Pediatric Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.