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General NPI Number Information
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NPI Number | 1992248959
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Entity Type | Individual
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Provider Name | CONRAD K. GOULD D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 125 CRESCENT PL
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City | YONKERS
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State | NY
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Zip | 10704-1603
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Country | US
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Telephone | 914-772-3835
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Fax |
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Provider Business Mailing Address
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Address Line | 7157 161ST ST APT 6A
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-4498
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Country | US
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Telephone | 914-772-3835
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 012882
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License Number State | NY
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