Provider Demographics
NPI:1790706265
Name:GORALEWICZ, RONALD WALTER (NP)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WALTER
Last Name:GORALEWICZ
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:205 E 78TH ST
Mailing Address - Street 2:17J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-1243
Mailing Address - Country:US
Mailing Address - Phone:212-861-4679
Mailing Address - Fax:212-861-4679
Practice Address - Street 1:205 E 78TH ST
Practice Address - Street 2:17J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-1243
Practice Address - Country:US
Practice Address - Phone:212-861-4679
Practice Address - Fax:212-861-4679
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY40-400141363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health