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General NPI Number Information
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NPI Number | 1245364975
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Entity Type | Individual
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Provider Name | JEFFREY STUART GOLD M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 365 MONTAUK AVE
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City | NEW LONDON
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State | CT
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Zip | 06320-4769
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Country | US
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Telephone | 203-688-0715
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Fax | 475-246-9062
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Provider Business Mailing Address
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Address Line | 10 JOLUDOW DR
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-3720
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Country | US
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Telephone | 516-729-6255
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Fax | 516-373-7219
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number | 216378
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 216378
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 28547
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 216378
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License Number State | NY
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