Active NPI
Phoowanai Gambino, RDN, CDN
- Registered Dietitian
- Hoboken, NJ
National Provider Identifier
1861865404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1101790
- Practice address
- 33-41 Newark St FL 5
Hoboken, NJ 07030-5627 - Phone
- (917) 647-1665
- Fax
- (201) 473-5812
- NPI assigned
- Nov 4, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DI200001566 | DC | |
| Registered Dietitian | 133V00000X | 1101790 | NY | Primary |
Addresses
Primary practice location
33-41 Newark St FL 5
Hoboken, NJ 07030-5627
Mailing address
7917 32ND Ave # 1
East Elmhurst, NY 11370-1831
Phone (917) 647-1665
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI200001566 | DC | MD | Registered Dietitian |
| 1101790 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fig Health, Inc | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745280000000",
"number": "1861865404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7917 32ND AVE # 1",
"city": "EAST ELMHURST",
"state": "NY",
"postal_code": "113701831",
"telephone_number": "917-647-1665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33-41 NEWARK ST FL 5",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070305627",
"telephone_number": "917-647-1665",
"fax_number": "201-473-5812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBINO",
"first_name": "PHOOWANAI",
"name_prefix": "Mr.",
"credential": "RDN, CDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-04",
"last_updated": "2025-04-22",
"certification_date": "2025-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "DC",
"license": "DI200001566",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "1101790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hoboken, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.