Provider Demographics
NPI:1073331237
Name:GOZON, ARIANE TAGAYUNA (FNP-C)
Entity type:Individual
Prefix:
First Name:ARIANE
Middle Name:TAGAYUNA
Last Name:GOZON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 W 164TH ST APT 31B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-0607
Mailing Address - Country:US
Mailing Address - Phone:917-880-2206
Mailing Address - Fax:
Practice Address - Street 1:625 W 164TH ST APT 31B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-0607
Practice Address - Country:US
Practice Address - Phone:917-880-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY355066363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily