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General NPI Number Information
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NPI Number | 1588272983
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Entity Type | Individual
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Provider Name | ALBERTO DE JESUS GONZALEZ ZACARIAS MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 147 LAKE ST
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City | NEWBURGH
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State | NY
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Zip | 12550-5263
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Country | US
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Telephone | 845-563-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2570 ROUTE 9W STE 10
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City | CORNWALL
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State | NY
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Zip | 12518-1370
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Country | US
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Telephone | 845-220-3100
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 323804
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License Number State | NY
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