Gabriella Gonzales, | |
2857 W Broad St, Columbus, OH 43204-2643 | |
(614) 722-6200 | |
(614) 355-9910 |
Full Name | Gabriella Gonzales |
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Gender | Female |
Speciality | Pediatrics |
Location | 2857 W Broad St, Columbus, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225591175 | NPI | - | NPPES |
0004017 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 35144552 (Ohio) | Secondary |
2080P0204X | Pediatrics - Pediatric Emergency Medicine | 35144552 (Ohio) | Secondary |
208000000X | Pediatrics | V0748 (Texas) | Primary |
Entity Name | Pediatric Academic Association, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063419943 PECOS PAC ID: 2961306774 Enrollment ID: O20031124000198 |
Mailing Address | Practice Location Address |
---|---|
Gabriella Gonzales, 700 Childrens Dr, Columbus, OH 43205-2664 Ph: (614) 722-2000 | Gabriella Gonzales, 2857 W Broad St, Columbus, OH 43204-2643 Ph: (614) 722-6200 |
Amrik Singh Khalsa, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 700 Childrens Dr, Columbus, OH 43205 Phone: 614-722-2000 Fax: 614-722-4966 | |
Sara Foley Schroder, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2857 W Broad St, Columbus, OH 43204 Phone: 614-722-6200 | |
Mr. Christopher Jones, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 700 Childrens Dr, Columbus, OH 43205 Phone: 614-722-2000 | |
Claire Elizabeth Christian, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 700 Childrens Dr, Columbus, OH 43205 Phone: 614-722-2000 | |
Laura Gardner Hamant, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 Childrens Dr, Columbus, OH 43205 Phone: 614-722-2000 | |
Valentina Gutierrez, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 80 E Rich St Apt 819, Columbus, OH 43215 Phone: 380-242-1699 | |
Leif Daniel Nelin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 700 Childrens Dr, Columbus, OH 43205 Phone: 614-722-4559 Fax: 614-722-4541 |