Provider Demographics
NPI:1609919695
Name:GOSSETT, JAMES D (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:GOSSETT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BONAVENTURE AVE
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2103
Mailing Address - Country:US
Mailing Address - Phone:914-693-0432
Mailing Address - Fax:
Practice Address - Street 1:3030 BROADWAY MC 1915
Practice Address - Street 2:COLUMBIA UNIVERSITY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-1915
Practice Address - Country:US
Practice Address - Phone:212-854-3178
Practice Address - Fax:212-854-4597
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000016-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer