Basic Information
| Provider Information | |||||||||
| NPI: | 1336627264 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GORELICK | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31 GREEN HILL RD | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064771211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035568449 | ||||||||
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| Practice Location | |||||||||
| Address1: | STAMFORD HEALTH | ||||||||
| Address2: | ONE HOSPITAL PLAZA | ||||||||
| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032761000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2018 | ||||||||
| LastUpdateDate: | 08/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | PENDING | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.