Provider Demographics
NPI:1255710513
Name:RAINFORD, ANN MARIE (CNA)
Entity type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:RAINFORD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 DEER PARK AVE # 359
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1208
Mailing Address - Country:US
Mailing Address - Phone:631-805-6696
Mailing Address - Fax:
Practice Address - Street 1:1488 DEER PARK AVE # 359
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1208
Practice Address - Country:US
Practice Address - Phone:631-805-6696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00116790374U00000X
NY343233840312E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide