MEDICARE: MR. SHELDON NEIL GOLD P.T.

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	225100000X	Physical Therapist	PT6007	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	341933152-00	OTHER	OH	OHIO W.C.

General Provider Information

NPI Number	:	1932230786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHELDON NEIL GOLD P.T.

Provider Business Mailing Address
First Line	:	6055 DEEPWOOD DR
Second Line	:
City	:	MORELAND HILLS
State	:	OH
Zip	:	44022-2569
Country	:	US
Telephone Number	:	216-407-4518
Fax Number	:

Provider Business Practice Location Address
First Line	:	2280 LEE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3433
Country	:	US
Telephone Number	:	216-407-4518
Fax Number	:

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/09/2007

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