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Organization

IRA A. GOULD,M.D.,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IRA A. GOULD M.D. (PHYSICIAN,PRESIDENT)
(212) 725-7185
Entity
Organization

Contact information

Practice address
365A WEST 28TH STREET, GROUND FLOOR, SUITE 1, NEW YORK, NY 10001-7901
(212) 725-7185
(212) 725-7168
Mailing address
365A WEST 28TH STREET, GROUND FLOOR, SUITE 1, NEW YORK, NY 10001-7901
(212) 725-7185
(212) 725-7168

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
094552
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00155633
NY
01
0042589
GHI
NY
01
094552-7
WORKERS' COMP. BOARD
NY
01
33D0956128
CLIA
NY
01
506221
BLUE CROSS BLUE SHIELD
NY
Enumeration date
05/15/2007
Last updated
03/16/2009
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