Provider Demographics
NPI:1417283052
Name:GOUVEIA, DAVID MICHAEL
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MICHAEL
Last Name:GOUVEIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SHORE RD APT 9A
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4377
Mailing Address - Country:US
Mailing Address - Phone:516-665-8779
Mailing Address - Fax:
Practice Address - Street 1:360 SHORE RD
Practice Address - Street 2:APT 9A
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4300
Practice Address - Country:US
Practice Address - Phone:516-665-8779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-01
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist