Provider Demographics
NPI:1215283999
Name:GOLD, DENA LAUREN (LAC)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:LAUREN
Last Name:GOLD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 UNION SQ E
Mailing Address - Street 2:615N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3209
Mailing Address - Country:US
Mailing Address - Phone:914-980-5185
Mailing Address - Fax:914-576-9425
Practice Address - Street 1:32 UNION SQ E
Practice Address - Street 2:615N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3209
Practice Address - Country:US
Practice Address - Phone:914-980-5185
Practice Address - Fax:914-576-9425
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25 004866171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist