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General NPI Number Information
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NPI Number | 1265787535
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Entity Type | Individual
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Provider Name | CHRISTINA GOULD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 404 E 91ST ST
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City | NEW YORK
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State | NY
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Zip | 10128-6807
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Country | US
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Telephone | 212-369-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 78 PROSPECT PARK W APT 2A
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City | BROOKLYN
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State | NY
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Zip | 11215-3077
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Country | US
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Telephone | 917-406-5350
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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