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Individual
MS. LUPE AMY GONZALEZ
Active
Individual
MS. LUPE AMY GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.P.T. L.AC. R.N.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR06203400
NJ
171100000X
Acupuncturist
Primary
25MZ00024400
NJ
225100000X
Physical Therapist
40QA00409000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
643392
PTAN
—
Enumeration date
10/11/2006
Last updated
07/21/2022
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