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General NPI Number Information
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NPI Number | 1144542002
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Entity Type | Individual
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Provider Name | ISEL GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 02/19/2010
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 909 BROAD ST
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City | NEWARK
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State | NJ
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Zip | 07102-2622
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Country | US
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Telephone | 973-643-5222
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Fax | 973-643-0319
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Provider Business Mailing Address
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Address Line | 226 NORTH AVE
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City | HILLSIDE
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State | NJ
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Zip | 07205-3116
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Country | US
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Telephone | 908-351-7081
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI01885100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS22843
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License Number State | FL
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