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NPI Code Detail

MEDICARE: LUCIANA GONZALEZ MSW

MEDICARE: LUCIANA GONZALEZ MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1053744102
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCIANA GONZALEZ MSW
Provider Business Mailing Address
First Line : 222 E 112TH ST
Second Line : APT 2
City : NEW YORK
State : NY
Zip : 10029-3078
Country : US
Telephone Number : 805-535-9163
Fax Number :
Provider Business Practice Location Address
First Line : 579 COURTLANDT AVE
Second Line :
City : BRONX
State : NY
Zip : 10451-5013
Country : US
Telephone Number : 718-485-2100
Fax Number : 718-485-2101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2013
Last Update Date : 08/13/2013

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