# FORT WASHINGTON MEDICAL OFFICE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205870078
- **Authorized official:** DR. FAUSTO A GONZALEZ MD (PARTNER/OWNER)
- **Authorized official phone:** (212) 927-0013

## Contact information

- **Practice address:** 65 FORT WASHINGTON AVE, NEW YORK, NY 10032-4634
- **Practice address phone:** (212) 927-0013
- **Practice address fax:** (212) 927-0014
- **Mailing address:** 65 FORT WASHINGTON AVE, NEW YORK, NY 10032-4634
- **Mailing address phone:** (212) 927-0013
- **Mailing address fax:** (212) 927-0014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 06/13/2023