Healthcare Provider Details

I. General information

NPI: 1033673116
Provider Name (Legal Business Name): NINA GOLDRICH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6735 112TH ST
FOREST HILLS NY
11375-2349
US

IV. Provider business mailing address

6735 112TH ST
FOREST HILLS NY
11375-2349
US

V. Phone/Fax

Practice location:
  • Phone: 718-263-0740
  • Fax: 718-263-9894
Mailing address:
  • Phone: 718-263-0740
  • Fax: 718-263-9894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number383849
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: