Healthcare Provider Details

I. General information

NPI: 1194158048
Provider Name (Legal Business Name): MARIGONA GASHI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MEADOWLANDS PKWY
SECAUCUS NJ
07094-2977
US

IV. Provider business mailing address

414 SMITH PL APT 1
RIDGEWOOD NJ
07450-1402
US

V. Phone/Fax

Practice location:
  • Phone: 917-679-2200
  • Fax:
Mailing address:
  • Phone: 917-679-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00377600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number016840
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: