Provider Demographics
NPI:1265448674
Name:GOLD, ANDREA (AUD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 VAN BUREN CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10930-2701
Mailing Address - Country:US
Mailing Address - Phone:914-843-8597
Mailing Address - Fax:
Practice Address - Street 1:RT. 9D
Practice Address - Street 2:VAHVHVS CASTLE POINT CAMPUS
Practice Address - City:CASTLE POINT
Practice Address - State:NY
Practice Address - Zip Code:12511
Practice Address - Country:US
Practice Address - Phone:845-838-5226
Practice Address - Fax:845-838-5266
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001195-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist