Organization
JUAN A GONZALEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN A GONZALEZ MD (PRESIDENT)
(201) 795-9080
Entity
Organization
Contact information
Practice address
3196 KENNEDY BLVD, 2ND FLOOR, UNION CITY, NJ 07087-2436
(201) 795-9080
(201) 795-9434
Mailing address
3196 KENNEDY BLVD, MAILBOX 16A, UNION CITY, NJ 07087-2436
(201) 795-9080
(201) 795-9434
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA07273600
NJ
208600000X
Surgery Physician
Primary
25MA4258800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003875
—
NJ
Enumeration date
10/03/2006
Last updated
01/04/2012
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