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NPI Code Detail

MEDICARE: DAISY GONZALES

MEDICARE: DAISY GONZALES
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1386991701
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAISY GONZALES
Provider Business Mailing Address
First Line : 2533 BELMONT AVE BSMT
Second Line :
City : BRONX
State : NY
Zip : 10458-5105
Country : US
Telephone Number : 646-667-0975
Fax Number :
Provider Business Practice Location Address
First Line : 579 COURTLANDT AVE
Second Line :
City : BRONX
State : NY
Zip : 10451-5013
Country : US
Telephone Number : 718-485-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2012
Last Update Date : 12/23/2019

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Directions to “ DAISY GONZALES ” Practice Location

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