Provider Demographics
NPI:1437431277
Name:GOLDSCHRAFE, PATRICIA (RN)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:GOLDSCHRAFE
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 1:22 EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:LAKE RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-2763
Mailing Address - Country:US
Mailing Address - Phone:631-585-6797
Mailing Address - Fax:
Practice Address - Street 1:207 HALLOCK RD SUITE 201
Practice Address - Street 2:INTERIM HEALTHCARE
Practice Address - City:STONYBROOK
Practice Address - State:NY
Practice Address - Zip Code:11790
Practice Address - Country:US
Practice Address - Phone:631-689-8920
Practice Address - Fax:631-689-8955
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY379632-1163W00000X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse