Provider Demographics
NPI:1063914737
Name:GORDHAN, RESHMI NAGINLALL (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:RESHMI
Middle Name:NAGINLALL
Last Name:GORDHAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:RESHMI
Other - Middle Name:NAGINLALL
Other - Last Name:GORDHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:125 WALKER STREET
Mailing Address - Street 2:NEW YORK
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:646-941-2213
Mailing Address - Fax:212-226-2289
Practice Address - Street 1:268 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3599
Practice Address - Country:US
Practice Address - Phone:212-941-2213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402609363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health