Provider Demographics
NPI:1952719403
Name:GOLD, RACHEL (DO)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 MIDDLE NECK RD
Mailing Address - Street 2:APT 3C
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1175
Mailing Address - Country:US
Mailing Address - Phone:646-408-7268
Mailing Address - Fax:
Practice Address - Street 1:260 MIDDLE NECK RD
Practice Address - Street 2:APT 3C
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1175
Practice Address - Country:US
Practice Address - Phone:646-408-7268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2675182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology