Provider Demographics
NPI:1578624250
Name:GOLATT, MINDY A (CPNP)
Entity Type:Individual
Prefix:MS
First Name:MINDY
Middle Name:A
Last Name:GOLATT
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 PELHAM PARKWAY
Mailing Address - Street 2:JACP 5C-15
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:718-918-4903
Mailing Address - Fax:718-918-4699
Practice Address - Street 1:1400 PELHAM PARKWAY
Practice Address - Street 2:JACP 5C-15
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-4903
Practice Address - Fax:718-918-4699
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF381449363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics