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General NPI Number Information
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NPI Number | 1750597167
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Entity Type | Organization
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Legal Business Name | IRA A. GOULD,M.D.,P.C.
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 365A WEST 28TH STREET GROUND FLOOR, SUITE 1
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City | NEW YORK
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State | NY
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Zip | 10001-7901
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Country | US
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Telephone | 212-725-7185
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Fax | 212-725-7168
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Provider Business Mailing Address
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Address Line | 365A WEST 28TH STREET GROUND FLOOR, SUITE 1
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City | NEW YORK
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State | NY
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Zip | 10001-7901
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Country | US
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Telephone | 212-725-7185
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Fax | 212-725-7168
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Authorized Official
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Title or Position | PHYSICIAN,PRESIDENT
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Name | DR. IRA A. GOULD
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Credential | M.D.
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Telephone | 212-725-7185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 094552
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License Number State | NY
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