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General NPI Number Information
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NPI Number | 1376537324
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Entity Type | Individual
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Provider Name | ANDREA GOULD PH. D.
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Gender | Female
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 26 SCHOOL HOUSE LN
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City | SYOSSET
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State | NY
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Zip | 11791-2618
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Country | US
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Telephone | 516-921-4333
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Fax | 516-364-5943
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Provider Business Mailing Address
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Address Line | 26 SCHOOL HOUSE LN
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City | SYOSSET
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State | NY
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Zip | 11791-2618
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Country | US
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Telephone | 516-921-4333
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Fax | 516-364-5943
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 004928
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License Number State | NY
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