Provider Demographics
NPI:1740029834
Name:MCGOLDRICK, ERIN EILEEN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:EILEEN
Last Name:MCGOLDRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:BLUE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11715-2006
Mailing Address - Country:US
Mailing Address - Phone:631-219-4497
Mailing Address - Fax:
Practice Address - Street 1:7 ROGERS ST # 14
Practice Address - Street 2:
Practice Address - City:BLUE POINT
Practice Address - State:NY
Practice Address - Zip Code:11715-2006
Practice Address - Country:US
Practice Address - Phone:631-219-4497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY542289-01163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy