Provider Demographics
NPI:1952661886
Name:GORENSTEIN, MAUREEN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:GORENSTEIN
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 1:7103 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6244
Mailing Address - Country:US
Mailing Address - Phone:718-444-5769
Mailing Address - Fax:
Practice Address - Street 1:7103 AVENUE T
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6244
Practice Address - Country:US
Practice Address - Phone:718-444-5769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY364886163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY364886OtherREG NURSE LICENCE #