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NPI Code Detail

MEDICARE: MELANIE GONZALEZ MD, MA

MEDICARE:   MELANIE  GONZALEZ  MD, MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramMT238138PA

General Provider Information

NPI Number : 1225962731
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE GONZALEZ MD, MA
Provider Business Mailing Address
First Line : 160 E ERIE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-1011
Country : US
Telephone Number : 215-427-8846
Fax Number :
Provider Business Practice Location Address
First Line : 160 E ERIE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-1011
Country : US
Telephone Number : 215-427-8846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/15/2026

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