Healthcare Provider Details

I. General information

NPI: 1669815486
Provider Name (Legal Business Name): PALOMA GONZALEZ PEREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 CAMBRIDGE ST FL 8
BOSTON MA
02114-2747
US

IV. Provider business mailing address

165 CAMBRIDGE ST FL 8
BOSTON MA
02114-2747
US

V. Phone/Fax

Practice location:
  • Phone: 617-724-7423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number270288
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberR-9618
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: