Individual
LIESEL L. GOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
451 STATE ST, NORTH HAVEN, CT 06473-3019
(203) 248-8888
(203) 248-8889
Mailing address
451 STATE ST, NORTH HAVEN, CT 06473-3019
(203) 248-8888
(203) 248-8889
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
035385
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001353838
—
CT
01
—
035383
CONNECTICARE
CT
01
—
OQ1356
HEALTHNET
CT
01
—
P652646
OXFORD
CT
Enumeration date
03/28/2006
Last updated
12/08/2011
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