Provider Demographics
NPI:1811198674
Name:GONERA, ANN MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ANN MARIE
Middle Name:
Last Name:GONERA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 FORT WASHINGTON AVE.
Mailing Address - Street 2:MILSTEIN HOSPITAL 8HS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-4686
Mailing Address - Fax:
Practice Address - Street 1:10198 SW VILLAGE PKWY STE 105
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2592
Practice Address - Country:US
Practice Address - Phone:772-934-4990
Practice Address - Fax:772-934-4991
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331208363LA2100X, 363LF0000X
FLAPRN11023607363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP55341Medicare UPIN