MEDICARE: SAMANTHA 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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1942156450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA GONZALEZ

Provider Business Mailing Address
First Line	:	1235 LONGFELLOW AVE
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-4911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 SPRUCE ST
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07501-1720
Country	:	US
Telephone Number	:	862-267-2057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ SAMANTHA GONZALEZ ” Practice Location

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