Provider Demographics
NPI:1760915045
Name:GOLD, MEIRA (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MEIRA
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5932 CROSS COUNTRY BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3833
Mailing Address - Country:US
Mailing Address - Phone:443-604-8679
Mailing Address - Fax:
Practice Address - Street 1:2 STACY CT
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2912
Practice Address - Country:US
Practice Address - Phone:732-664-8874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2019-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00773100225X00000X
MD07331225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist