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General NPI Number Information
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NPI Number | 1275793101
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Entity Type | Individual
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Provider Name | PIERRE J. GONSALVES MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 315 S MANNING BLVD
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City | ALBANY
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State | NY
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Zip | 12208-1707
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Country | US
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Telephone | 518-525-1550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15645 SMA MEDICAL STAFF OFFICE
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City | LAS VEGAS
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State | NV
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Zip | 89114-5645
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Country | US
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Telephone | 702-560-2874
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA08969100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2014025197
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 13624
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 257747
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | C173014
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 257747
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License Number State | NY
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