Provider Demographics
NPI:1942252614
Name:GOOLD, KRISTIN LONGHOUSE (RPH)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:LONGHOUSE
Last Name:GOOLD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 654
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:NY
Mailing Address - Zip Code:14485-0654
Mailing Address - Country:US
Mailing Address - Phone:585-624-9777
Mailing Address - Fax:585-624-5677
Practice Address - Street 1:7298 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:NY
Practice Address - Zip Code:14485-9473
Practice Address - Country:US
Practice Address - Phone:585-624-9777
Practice Address - Fax:585-624-5677
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist