Provider Demographics
NPI:1114001070
Name:GOLD, ALLISON (MSW,LCSWR)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:MSW,LCSWR
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:GOLD, LSCWR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSWR
Mailing Address - Street 1:50 E 42ND ST
Mailing Address - Street 2:SUITE 507
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5405
Mailing Address - Country:US
Mailing Address - Phone:212-535-2901
Mailing Address - Fax:212-535-9854
Practice Address - Street 1:50 E 42ND ST
Practice Address - Street 2:SUITE 507
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5405
Practice Address - Country:US
Practice Address - Phone:212-535-2901
Practice Address - Fax:212-535-9854
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0534581R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1061820Medicare UPIN