1528115565 NPI number — ROBERT F. GOULD, INC

Table of content: (NPI 1528115565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528115565 NPI number — ROBERT F. GOULD, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT F. GOULD, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528115565
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 TOLL GATE RD
Provider Second Line Business Mailing Address:
SUITE 302
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02886-4458
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-738-9953
Provider Business Mailing Address Fax Number:
401-738-7555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 TOLL GATE RD
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
WARWICK
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02886-4458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-738-9953
Provider Business Practice Location Address Fax Number:
401-738-7555
Provider Enumeration Date:
01/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PULEO
Authorized Official First Name:
HOLLY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
AUDIOLOGIST
Authorized Official Telephone Number:
401-738-9953

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  127 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 45-00027 . This is a "UNITEDHEALTHPLAN" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 24057-0 . This is a "BLUE CROSS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 11616402 . This is a "AMERICHOICE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 402563 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: BH00020 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06210 . This is a "HEARUSA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 2102 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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