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IVON LESTARI GOUTAMA MD
NPI 1649030297
Student in an Organized Health Care Education/Training Program in Bronx, NY

Active since March 20, 2024
1650 GRAND CONCOURSE, BRONX, NY 10457(718) 960-1449(718) 518-5124 Get Directions Write a Review

NPPES record last updated: March 20, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Ivon Lestari Goutama Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IVON LESTARI GOUTAMA MD (NPI 1649030297) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1649030297
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameIVON LESTARI GOUTAMACredential: MD
Location Address1650 GRAND CONCOURSEBronx, NY 10457-7697
Mailing Address640 W 237th St Apt 11aBronx, NY 10463-1453 · (929) 245-2803
Phone(718) 960-1449
Fax(718) 518-5124
Sole ProprietorNo
Enumeration DateMarch 20, 2024
NPPES CertifiedMarch 20, 2024
✔ NPI 1649030297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1650 GRAND CONCOURSE, Bronx, NY 10457
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSIE LAUREN GREEN M.S., CCC-SLP
Speech-Language Pathologist
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (201) 281-3781
ARAMARK
Clinic/Center
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (646) 641-7427
MAY YEE HELMAN M.D.
Emergency Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (718) 992-7669
ANDREA ELIZABETH SPIEKHOUT D.O.
Family Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (718) 992-7669
VINCENT SETIAWAN PRAWOKO MD
Student in an Organized Health Care Education/Training Program
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (347) 601-1241
HAIDER GHAZANFAR
Internal Medicine (Gastroenterology)
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (917) 856-6383
MATTHEW PEACHEY MD
Internal Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (718) 992-7669
TRACY RAU MD
Family Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (718) 590-1800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ivon Lestari Goutama's NPI number?

The NPI number for Ivon Lestari Goutama is 1649030297. It was assigned to this individual provider in the NPPES registry on March 20, 2024.

Where is Ivon Lestari Goutama located?

Ivon Lestari Goutama practices at 1650 Grand Concourse, Bronx, NY 10457. The listed phone number is (718) 960-1449.

What is Ivon Lestari Goutama's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Ivon Lestari Goutama was last updated on March 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.