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General NPI Number Information
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NPI Number | 1497709091
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Entity Type | Individual
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Provider Name | EMELITO GONZALES M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 707 E MAIN ST
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2650
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Country | US
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Telephone | 845-695-5999
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Fax | 845-695-5832
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Provider Business Mailing Address
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Address Line | 2 LAKE ST SUITE 201
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City | MONROE
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State | NY
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Zip | 10950-3542
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Country | US
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Telephone | 845-837-1388
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Fax | 845-837-1389
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 25MA03439400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 1254391
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License Number State | NY
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