MEDICARE: TOMMI-ANN GANGI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	408225	NY

General Provider Information

NPI Number	:	1093646705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOMMI-ANN GANGI

Provider Business Mailing Address
First Line	:	53 SPEEDWELL AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3261
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	53 SPEEDWELL AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3261
Country	:	US
Telephone Number	:	347-215-4884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “ TOMMI-ANN GANGI ” Practice Location

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