Individual provider · Type 1 NPI

Lori Ann Gough ST John

Medical Physician Assistant · New York, NY

NPI number 1194072140 Active

Practice location

525 E 68th St
New York, NY 10065-4870

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X015846 (NY)

Medical Physician Assistant: Definition to come...

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About NPI 1194072140

Lori Ann Gough ST John's National Provider Identifier is 1194072140, issued on Aug 9, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in New York, NY. The record was last updated on Mar 20, 2025.