Irina Gavdanovich, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00959500 Issued in NJ

Practice address

170 Prospect Ave Ste 1
Hackensack, NJ 07601-1834

Phone

(201) 820-3596

NPI assigned

Sep 12, 2017

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Anchipolovsky PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Oradell, NJ
  • NPI 1396922886
  Medicare reassignment NPD

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1780103580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 PROSPECT AVE STE 1",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011834",
            "telephone_number": "201-820-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PROSPECT AVE STE 1",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011834",
            "telephone_number": "201-820-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVDANOVICH",
        "first_name": "IRINA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00959500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin Jeffrey Garino, DDS
• Gary D. Schwartz, MD PC
• Luningning Castro Gatchalian, MD
• Sandra Lee Gauker, RN, APN, C.
• Nelly Gavalakis, APN-C
• Noha Gayed, MD
• Lauren Stacy Gayoso-Acuna
• Helen Negash Gebre
• Kerry Geddis
• Bryan Geiger, BSN, RN

• Family Nurse Practitioner in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.