Provider Demographics
NPI:1427220086
Name:RAINFORD, PEARLINA (NP)
Entity Type:Individual
Prefix:
First Name:PEARLINA
Middle Name:
Last Name:RAINFORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:PEARLINA
Other - Middle Name:M
Other - Last Name:RAINFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:15905 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366
Mailing Address - Country:US
Mailing Address - Phone:718-380-9500
Mailing Address - Fax:
Practice Address - Street 1:15905 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366
Practice Address - Country:US
Practice Address - Phone:718-380-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4176571163W00000X
NYF3037621363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse