Basic Information
| Provider Information | |||||||||
| NPI: | 1649571209 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOULD | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1329 BEACH CHANNEL DRIVE | ||||||||
| Address2: | |||||||||
| City: | FAR ROCKAWAY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 116913211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183376850 | ||||||||
| FaxNumber: | 7188683782 | ||||||||
| Practice Location | |||||||||
| Address1: | 1329 BEACH CHANNEL DR | ||||||||
| Address2: | |||||||||
| City: | FAR ROCKAWAY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 116913211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183376850 | ||||||||
| FaxNumber: | 7188683782 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2010 | ||||||||
| LastUpdateDate: | 11/12/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN21-3557 | NY | Y | Nursing Service Providers | Registered Nurse | 163WP0809X | RN21-3557 | NY | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.