Mary Gundersen, RN, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

385302-1 Issued in NY

Practice address

242 Mason Ave
Diabetes Education - 1St Floor
Staten Island, NY 10305-3408

Phone

(718) 226-1547

Fax

(718) 226-1438

NPI assigned

Nov 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Kamin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1932436854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MASON AVE",
            "address_2": "DIABETES EDUCATION - 1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-1547",
            "fax_number": "718-226-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MASON AVE",
            "address_2": "DIABETES EDUCATION - 1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-1547",
            "fax_number": "718-226-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-13",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "385302-1",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "0942-0278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KAMIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shurland D Gumbs-Noel
• Larisa Gumerova, PA-C
• Mallika Gunaratne, RN, BSN
• Manusha Gunawardana
• Roshani Gunawardena
• Mehtap Guney, M.S. SPED.
• Jenny P Guo, MD
• Amy Gupiteo, F. N. P.
• Anupam Gupta, M.D.
• Jennifer A Gurevich, L.M.S.W.

• Diabetes Educator Registered Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Diabetes Educator Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.