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General NPI Number Information
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NPI Number | 1497908123
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Entity Type | Organization
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Legal Business Name | ROSARIO GOULD LLC
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Dates
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Enumeration Date | 10/26/2008
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Last Update Date | 10/26/2008
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Provider Practice Location Address
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Address Line | 12 SHERBROOKE RD
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City | HARTSDALE
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State | NY
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Zip | 10530-2939
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Country | US
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Telephone | 914-693-0502
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Fax | 914-693-6991
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Provider Business Mailing Address
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Address Line | 12 SHERBROOKE RD
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City | HARTSDALE
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State | NY
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Zip | 10530-2939
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Country | US
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Telephone | 914-693-0502
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Fax | 914-693-6991
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ROSARIO GONZALEZ GOULD
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Credential | M.A.
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Telephone | 914-693-0502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 009289-1
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License Number State | NY
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