Provider Demographics
NPI:1982649851
Name:GORALSKI, SAUNDRA (CRNP)
Entity Type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:
Last Name:GORALSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SAUNDRA
Other - Middle Name:
Other - Last Name:JAWANOWITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2801 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3862
Mailing Address - Country:US
Mailing Address - Phone:410-342-0333
Mailing Address - Fax:
Practice Address - Street 1:2801 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3862
Practice Address - Country:US
Practice Address - Phone:410-342-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR104154363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0024OtherBCBS BLUECHOICE
MD663105300Medicaid
MD687066-02OtherBCBS (MD)
DC0024OtherBCBS BLUECHOICE
MD539P096HMedicare PIN