| Fermin P Gonzalez Md Pc | |
|
102-11 Roosevelt Ave Corona NY 11368-2331 | |
| (718) 898-5200 | |
| (718) 898-3673 |
| Full Name | Fermin P Gonzalez Md Pc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 102-11 Roosevelt Ave, Corona, New York |
| Authorized Official Name and Position | Fermin P Gonzalez (DOCTOR) |
| Authorized Official Contact | 7188985200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fermin P Gonzalez Md Pc 102-11 Roosevelt Ave Corona NY 11368-2331 Ph: (718) 898-5200 | Fermin P Gonzalez Md Pc 102-11 Roosevelt Ave Corona NY 11368-2331 Ph: (718) 898-5200 |
| NPI Number | 1639377849 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 03/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639377849 | NPI | - | NPPES |
| 205495 | Other | NY | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 205495 (New York) | Primary |
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