Provider Demographics
NPI:1205142726
Name:GOLDMAN-PATIN, CINDI LYNN (AGNP-C, CRNP, RN,)
Entity type:Individual
Prefix:MRS
First Name:CINDI
Middle Name:LYNN
Last Name:GOLDMAN-PATIN
Suffix:
Gender:F
Credentials:AGNP-C, CRNP, RN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 FEDERAL ST APT 2G
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6238
Mailing Address - Country:US
Mailing Address - Phone:413-770-4774
Mailing Address - Fax:
Practice Address - Street 1:67 FEDERAL ST APT 2G
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6238
Practice Address - Country:US
Practice Address - Phone:413-770-4774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA271625163WD0400X
NYF311732363LA2200X
MARN271625363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator