Provider Demographics
NPI:1285933010
Name:GOULD, CHELSEA Y
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:Y
Last Name:GOULD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 OSPREY LN
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-1821
Mailing Address - Country:US
Mailing Address - Phone:352-359-8297
Mailing Address - Fax:
Practice Address - Street 1:788 SHREWSBURY AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3080
Practice Address - Country:US
Practice Address - Phone:732-758-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor