Richard Gould, CRNP | |
5649 Wynnewood Dr Ste 104, Laurys Station, PA 18059-1124 | |
(610) 262-6641 | |
Not Available |
Full Name | Richard Gould |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 5649 Wynnewood Dr Ste 104, Laurys Station, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366137465 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | SP027406 (Pennsylvania) | Primary |
Entity Name | Lehigh Valley Physician Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457309650 PECOS PAC ID: 3072425123 Enrollment ID: O20040227000335 |
Entity Name | Hazleton Professional Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952464638 PECOS PAC ID: 8022110402 Enrollment ID: O20070305000195 |
Mailing Address | Practice Location Address |
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Richard Gould, CRNP 2100 Mack Blvd, Allentown, PA 18103-5622 Ph: (484) 884-4500 | Richard Gould, CRNP 5649 Wynnewood Dr Ste 104, Laurys Station, PA 18059-1124 Ph: (610) 262-6641 |
Ashley Williams, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5649 Wynnewood Dr Ste 104, Laurys Station, PA 18059 Phone: 610-262-0428 | |
Kelsey Emery, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5649 Wynnewood Dr Ste 203, Laurys Station, PA 18059 Phone: 610-261-1123 |