Stephanie Nicole Gordin, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

310437 Issued in NY

Practice address

7954 Jericho Tpke
Woodbury, NY 11797-1204

Phone

(917) 294-8710

NPI assigned

Sep 23, 2021

Last updated

Sep 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1881365419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7954 JERICHO TPKE",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971204",
            "telephone_number": "917-294-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7954 JERICHO TPKE",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971204",
            "telephone_number": "917-294-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDIN",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Email",
            "affiliation": "N",
            "endpointDescription": "Emai",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7954 Jericho Tpke",
            "city": "Woodbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117971204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cosmedoctor.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Contact info",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Contact info",
            "address_1": "7954 Jericho Tpke",
            "city": "Woodbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117971204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cosmedoctor.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Contact info",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Contact info",
            "address_1": "7954 Jericho Tpke",
            "city": "Woodbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117971204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Beth Goldstein, LCSW
• Harvey G Goldwasser, DDS
• Jacqueline Gomez, LPN
• Josue E Gomez, AGNP-C
• Shirley Goodman, MD
• Lee Farrell Green, M.S.ED
• Greenberg Medical Services PC
• Garred Samuel Greenberg, MD
• Stephen Todd Greenberg, MD
• Greenhaus Physical Therapy PC

• Adult Health Nurse Practitioner in Woodbury, NY
• Providers in Woodbury, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.