MEDICARE: DANIELA MARIA GONZALEZ MARTINEZ MA, LCAT

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	101200000X	Drama Therapist	003084	NY

General Provider Information

NPI Number	:	1679407357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELA MARIA GONZALEZ MARTINEZ MA, LCAT

Provider Business Mailing Address
First Line	:	535 CARLTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-4459
Country	:	US
Telephone Number	:	787-529-5497
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 CARLTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-4459
Country	:	US
Telephone Number	:	787-529-5497
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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