Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lori Ann Gough St John

Individual provider Medical Physician Assistant · NPI 1194072140

Lori Ann Gough St John is a Medical Physician Assistant in New York, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012

Practice location Address checks out

525 E 68th St
New York, NY 10065-4870
Phone: (212) 746-5454
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 015846 (NY)

Record details

NPI number1194072140
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 9, 2012
Last updated in NPPESMarch 20, 2025
Certification dateMarch 20, 2025

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