MEDICARE: HEATHER GOLD M.D.

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	207VC0300X	Complex Family Planning Physician	318453	NY
2	207V00000X	Obstetrics & Gynecology Physician	318453	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84624	OTHER	GA	GEORGIA COMPOSITE MEDICAL BOARD LICENSE CARD

General Provider Information

NPI Number	:	1417303686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER GOLD M.D.

Provider Business Mailing Address
First Line	:	100 E 77TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1850
Country	:	US
Telephone Number	:	212-434-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E 77TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1850
Country	:	US
Telephone Number	:	212-434-2000
Fax Number	:

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

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	02/02/2026

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Directions to “ HEATHER GOLD M.D.” Practice Location

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