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General NPI Number Information
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NPI Number | 1225175797
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Entity Type | Individual
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Provider Name | RICHARD EDWARD GONZALEZ R.PH.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 25707 UNION TPKE
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City | GLEN OAKS
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State | NY
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Zip | 11004-1250
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Country | US
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Telephone | 718-343-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 35 DEEPDALE PKWY
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-2301
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Country | US
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Telephone | 516-621-8916
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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 | 030806
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License Number State | NY
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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 | 31786
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS17939
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License Number State | FL
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