Provider Demographics
NPI:1720512627
Name:GOULD CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:GOULD CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CONRAD
Authorized Official - Middle Name:KAISER
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-772-3835
Mailing Address - Street 1:125 CRESCENT PL
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1603
Mailing Address - Country:US
Mailing Address - Phone:914-772-3835
Mailing Address - Fax:
Practice Address - Street 1:125 CRESCENT PLACE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704
Practice Address - Country:US
Practice Address - Phone:914-772-3835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty