Provider Demographics
NPI:1285952580
Name:RAND, GEORGE I (NP)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:I
Last Name:RAND
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E 10TH ST
Mailing Address - Street 2:APT. #5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5066
Mailing Address - Country:US
Mailing Address - Phone:212-473-1607
Mailing Address - Fax:
Practice Address - Street 1:313 E 10TH ST
Practice Address - Street 2:APT. #5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-5066
Practice Address - Country:US
Practice Address - Phone:212-473-1607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300144-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health