MEDICARE: MISS DAWNETTE VERA PATRICE GONZAGUE M.D.

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1508793399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DAWNETTE VERA PATRICE GONZAGUE M.D.

Provider Business Mailing Address
First Line	:	736 WILLOUGHBY AVE
Second Line	:	APT 5B
City	:	BROOKLYN
State	:	NY
Zip	:	11206
Country	:	US
Telephone Number	:	758-729-2018
Fax Number	:

Provider Business Practice Location Address
First Line	:	MERCY HEALTH ANDERSON HOSPITAL EMERGENCY MEDICINE RESID
Second Line	:	7500 STATE ROAD
City	:	CINCINNATI
State	:	OH
Zip	:	45255
Country	:	US
Telephone Number	:	513-624-4550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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