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NPI Code Detail

MEDICARE: DAISY GONZALEZ

MEDICARE: DAISY GONZALEZ
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
1164W00000XLicensed Practical Nurse349386NY

General Provider Information

NPI Number : 1255151296
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAISY GONZALEZ
Provider Business Mailing Address
First Line : 462 S LONG BEACH AVE
Second Line :
City : FREEPORT
State : NY
Zip : 11520-5514
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1115 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-5019
Country : US
Telephone Number : 516-344-9731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2024
Last Update Date : 10/15/2024

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Directions to “ DAISY GONZALEZ ” Practice Location

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