Provider Demographics
NPI:1346634433
Name:GINGOLD, JULIAN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:
Last Name:GINGOLD
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 S CENTRAL AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2337
Mailing Address - Country:US
Mailing Address - Phone:914-997-1060
Mailing Address - Fax:914-997-1090
Practice Address - Street 1:141 S CENTRAL AVE STE 201
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2337
Practice Address - Country:US
Practice Address - Phone:914-997-1060
Practice Address - Fax:914-997-1090
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.129902207V00000X
390200000X
NY297659-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program