MEDICARE: DR. BRUCE E. GOULD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	029114	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104837541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE E. GOULD M.D.

Provider Business Mailing Address
First Line	:	131 COVENTRY ST
Second Line	:	BURGDORF CLINIC - 2ND FLOOR
City	:	HARTFORD
State	:	CT
Zip	:	06112-1548
Country	:	US
Telephone Number	:	860-714-3690
Fax Number	:	860-714-8683

Provider Business Practice Location Address
First Line	:	131 COVENTRY ST
Second Line	:	BURGDORF CLINIC - 2ND FLOOR
City	:	HARTFORD
State	:	CT
Zip	:	06112-1548
Country	:	US
Telephone Number	:	860-714-3690
Fax Number	:	860-714-8683

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/29/2010

Similar Medicare Providers

1346828381 — ALVARO JOSE AYALA MD
Practice Location Address:

131 COVENTRY ST
HARTFORD, CT
06112-1548

Practice Phone: 860-714-3690
Practice Fax: 860-714-8541

1982613303 — DR. JODY LYNN TERRANOVA DO
Practice Location Address:

131 COVENTRY ST , 2ND FLOOR
HARTFORD, CT
06112-1548

Practice Phone: 860-714-3690
Practice Fax: 860-714-8683

1174535587 — DR. KEITH VOMEIGEN M.D.
Practice Location Address:

131 COVENTRY ST , BURGDORF CLINIC 2ND FLOOR - ADMINISTRATION
HARTFORD, CT
06112-1548

Practice Phone: 860-714-2813
Practice Fax: 860-714-8541

1366454621 — DR. GRAEL O'BRIEN M.D.
Practice Location Address:

131 COVENTRY ST , BURGDORF CLINIC - 2ND FLOOR ADMINISTRATION
HARTFORD, CT
06112-1548

Practice Phone: 860-714-3690
Practice Fax: 860-714-8683

1427060805 — DR. ELLEN OLARSCH NESTLER M.D.
Practice Location Address:

131 COVENTRY ST , BURGDORF CLINIC 2ND FLOOR - ADMINISTRATION
HARTFORD, CT
06112-1548

Practice Phone: 860-714-3690
Practice Fax: 860-714-8683

1568474088 — DR. PATRICIA M JOYCE M.D.
Practice Location Address:

131 COVENTRY ST , BURGDORF CLINIC 2ND FLOOR ADMINISTRATION
HARTFORD, CT
06112-1548

Practice Phone: 860-714-3690
Practice Fax: 860-714-8683

Directions to “ DR. BRUCE E. GOULD M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.