MEDICARE: JONATHAN GOULD DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1695	NY

General Provider Information

NPI Number	:	1407903446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN GOULD DC

Provider Business Mailing Address
First Line	:	50 ROSE PL
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-5311
Country	:	US
Telephone Number	:	888-279-6336
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 ROSE PL
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-5311
Country	:	US
Telephone Number	:	888-279-6336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	05/27/2026

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