Provider Demographics
NPI:1659848604
Name:GORIN, ALISON (NP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:GORIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615B PICCARD DR # B
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6698
Mailing Address - Country:US
Mailing Address - Phone:240-449-3094
Mailing Address - Fax:
Practice Address - Street 1:1615B PICCARD DR # B
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6698
Practice Address - Country:US
Practice Address - Phone:240-449-3094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2323583363LA2200X
MD202685363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health