Organization
CORTELYOU ROAD PEDIATRICS
Active
Parent organization
JAMES W GOUGH, M.D.
Organization subpart
Yes
Provider details
NPI number
Legal business name
JAMES W GOUGH, M.D.
Authorized official
DR. JMAES WILLIAM GOUGH M.D. (OWNER)
(718) 282-0170
Entity
Organization
Contact information
Practice address
1103 CORTELYOU RD, BROOKLYN, NY 11218-5303
(718) 282-0170
(718) 282-1008
Mailing address
1103 CORTELYOU RD, BROOKLYN, NY 11218-5303
(718) 282-0170
(718) 282-1008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
137428
NY
Other
Enumeration date
12/28/2011
Last updated
12/28/2011
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