Provider Demographics
NPI:1497908123
Name:ROSARIO GOULD LLC
Entity Type:Organization
Organization Name:ROSARIO GOULD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:GONZALEZ
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:914-693-0502
Mailing Address - Street 1:12 SHERBROOKE RD
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2939
Mailing Address - Country:US
Mailing Address - Phone:914-693-0502
Mailing Address - Fax:914-693-6991
Practice Address - Street 1:12 SHERBROOKE RD
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2939
Practice Address - Country:US
Practice Address - Phone:914-693-0502
Practice Address - Fax:914-693-6991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-26
Last Update Date:2008-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009289-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency