IRINA GAVDANOVICH


Address: 170 Prospect Ave Ste 1, Hackensack, NJ 07601-1834
Phone: 2018203596

IRINA GAVDANOVICH (NPI# 1780103580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780103580
Entity Type Individual
Full Name IRINA GAVDANOVICH
Credential FNP
Practice Address 170 Prospect Ave Ste 1
Hackensack
NJ 07601-1834
Practice Telephone 2018203596
Mailing Telephone 2018203596
Enumeration Date 2017-09-12
Last Update Date 2020-09-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
26NJ00959500 NJ Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1 Normal Ave, Montclair, NJ 070431624 9736554361

Office Location

Street Address 170 PROSPECT AVE STE 1
City HACKENSACK
State NJ
Zip Code 07601-1834

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1649825233 Rachel Korenblit Social Worker 235 Main St Ste 203, Hackensack, NJ 07601 2019-08-09
1740846567 Samantha Pirnat Counselor 426 Hudson Street, 2nd Floor, Hackensack, NJ 07601 2019-05-16
1881258499 Tara Lynn Smith Social Worker 160 South River Street, Hackensack, NJ 07601 2019-04-29
1922569318 Solomon Isakov Dentist 835 Prospect Ave, Suite 304, Hackensack, NJ 07601 2019-03-27
1114403409 Mildred Lopez Vasquez Home Health Aide 12 Rowland Avenue, Hackensack, NJ 07601 2018-07-19
1538656582 Zara Pharmacy LLC Pharmacy 57 Linden St, Hackensack, NJ 07601 2018-04-16
1447759048 Maryann Hom Social Worker 307 Prospect Avenue, 14e, Hackensack, NJ 07601 2018-02-08
1699274258 Kirsten Byrnes Psychologist Audrey Hepburn Children's House, Hackensack Umc, 12 Second St, Hackensack, NJ 07601 2018-02-08
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437629367 Toni Tortorella Genova Nurse Practitioner 75 Essex St Ste 100, Hackensack, NJ 07601-4034 2018-12-04
1952735847 Laura B Maccone Nurse Practitioner 20 Prospect Ave Ste 602, Hackensack, NJ 07601-1962 2013-08-27
1891031530 April Quatrano Nurse Practitioner 457 Blanchard Ter Apt 4, Hackensack, NJ 07601-1452 2012-12-28
1114532173 Caroline Castro Nurse Practitioner 30 Prospect Ave, Hackensack, NJ 07601-1915 2020-09-15
1710500780 Ferdinand Pontejos Nurse Practitioner 30 Prospect Ave, Hackensack, NJ 07601-1915 2020-05-25
1497389407 Hannah Helms Rigney Nurse Practitioner 92 2nd St, Hackensack, NJ 07601-2191 2020-02-28
1821638388 Karla Oliveri Nurse Practitioner 30 Prospect Ave, Hackensack, NJ 07601-1915 2020-01-13
1770124828 Maria Christina Zayas Nurse Practitioner 30 Prospect Ave, Hackensack, NJ 07601-1915 2019-09-30
1457992679 Carmen Cecilia Peralta Nurse Practitioner 20 Prospect Ave, Hackensack, NJ 07601-1997 2019-09-30
1164074746 Stephanie Y Kim Nurse Practitioner 92 Summit Ave, Hackensack, NJ 07601-1263 2019-07-12
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Competitor

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City HACKENSACK
Zip Code 07601

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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