Charmaine Jackqulin Gonzales, ANP | |
8923 Flatlands Ave, Brooklyn, NY 11236-3613 | |
(718) 765-6000 | |
(347) 436-9621 |
Full Name | Charmaine Jackqulin Gonzales |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Adult Health |
Location | 8923 Flatlands Ave, Brooklyn, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659697878 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LA2200X | Nurse Practitioner - Adult Health | 305324 (New York) | Primary |
Entity Name | Pervaiz Iqbal Physician Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477765469 PECOS PAC ID: 6204097264 Enrollment ID: O20120418000482 |
Mailing Address | Practice Location Address |
---|---|
Charmaine Jackqulin Gonzales, ANP Po Box 746087, Atlanta, GA 30374-6087 Ph: (312) 733-9730 | Charmaine Jackqulin Gonzales, ANP 8923 Flatlands Ave, Brooklyn, NY 11236-3613 Ph: (718) 765-6000 |
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