Provider Demographics
NPI:1144594037
Name:NASH, RAFFAELLA M (RN)
Entity Type:Individual
Prefix:
First Name:RAFFAELLA
Middle Name:M
Last Name:NASH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HALLOCK LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8938
Mailing Address - Country:US
Mailing Address - Phone:631-849-3281
Mailing Address - Fax:
Practice Address - Street 1:525 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8885
Practice Address - Country:US
Practice Address - Phone:631-849-7410
Practice Address - Fax:631-744-4898
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341021-1163W00000X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse