Provider Demographics
NPI:1790531440
Name:MOULD, GERALDINE KORDAI (MD)
Entity type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:KORDAI
Last Name:MOULD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KORDAI
Other - Middle Name:GERALDINE
Other - Last Name:MOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:506 LENOX AVENUE
Mailing Address - Street 2:RM-13-106-MLK
Mailing Address - City:HARLEM
Mailing Address - State:NY
Mailing Address - Zip Code:10037
Mailing Address - Country:US
Mailing Address - Phone:212-939-1406
Mailing Address - Fax:
Practice Address - Street 1:506 LENOX AVENUE
Practice Address - Street 2:RM-13-106-MLK
Practice Address - City:HARLEM
Practice Address - State:NY
Practice Address - Zip Code:10037
Practice Address - Country:US
Practice Address - Phone:212-939-1406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program