Provider Demographics
NPI:1962110569
Name:ROCHFORD, KIRAH Z (RN)
Entity type:Individual
Prefix:
First Name:KIRAH
Middle Name:Z
Last Name:ROCHFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CARTWRIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-3622
Mailing Address - Country:US
Mailing Address - Phone:917-362-8533
Mailing Address - Fax:
Practice Address - Street 1:12610 BEDELL ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3141
Practice Address - Country:US
Practice Address - Phone:718-276-1348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY691665163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics