Healthcare Provider Details

I. General information

NPI: 1275715328
Provider Name (Legal Business Name): ROXANNE GONZALEZ-MCGIVNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S JACOBI MEDICAL CENTER BLDG 6 UNIT 8A
BRONX NY
10461-1138
US

IV. Provider business mailing address

3420 32ND ST APT 5C
ASTORIA NY
11106-2776
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-6740
  • Fax:
Mailing address:
  • Phone: 718-918-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: