Provider Demographics
NPI:1760603062
Name:GAWRONSKI, CATHERINE (GNP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:GAWRONSKI
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BRUNDAGE ST.
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907
Mailing Address - Country:US
Mailing Address - Phone:203-961-8538
Mailing Address - Fax:
Practice Address - Street 1:1060 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1715
Practice Address - Country:US
Practice Address - Phone:212-316-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302772-1363LA2200X
NYF340428-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF340428-1OtherNURSE PRACTITIONER IN GERONTOLOGY
NYF302772-1OtherNURSE PRACTITIONER IN ADULT HEALTH
NYMG0592116OtherNYS DEA