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NPI Code Detail

MEDICARE: ELIZABETH GONZALEZ

MEDICARE: ELIZABETH GONZALEZ
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
1225XP0019XPhysical Rehabilitation Occupational TherapistOT01621RI

General Provider Information

NPI Number : 1881108736
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH GONZALEZ
Provider Business Mailing Address
First Line : 87 RHODE ISLAND LINE RD
Second Line :
City : PUTNAM
State : CT
Zip : 06260-2612
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20 AUSTIN AVE
Second Line :
City : GREENVILLE
State : RI
Zip : 02828-1449
Country : US
Telephone Number : 401-949-3880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2017
Last Update Date : 11/29/2017

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Directions to “ ELIZABETH GONZALEZ ” Practice Location

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