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General NPI Number Information
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NPI Number | 1386462257
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Entity Type | Individual
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Provider Name | ANDREW GONZALEZ
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Gender |
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 60 PLAZA ST E APT 1G
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City | BROOKLYN
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State | NY
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Zip | 11238-5030
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Country | US
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Telephone | 318-485-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 302 CALLE PEDRO BIGAY
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City | SAN JUAN
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State | PR
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Zip | 00918-4023
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Country | US
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Telephone | 503-781-5896
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 116070
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License Number State | NY
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