Organization
LUIS F GONZALEZ, III, MD, PC
Active
Other names
Champlain Valley Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
(502) 477-1815
Entity
Organization
Contact information
Practice address
118 CONSUMER SQ, PLATTSBURGH, NY 12901-6507
(518) 562-3650
(518) 562-3801
Mailing address
118 CONSUMER SQ, PLATTSBURGH, NY 12901-6507
(518) 562-3650
(518) 562-3801
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1718890
—
NY
Enumeration date
05/23/2005
Last updated
06/12/2008
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