Individual
MISS MELANIE GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4915 BROADWAY, SUITE 1B, NEW YORK, NY 10034-3119
(212) 567-9580
(212) 567-9582
Mailing address
75 ITHACA AVE, ATLANTIC BEACH, NY 11509-1322
(917) 805-1752
(516) 239-6125
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011503
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011503
LICENSE
NY
Enumeration date
03/26/2007
Last updated
03/23/2010
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