Individual
MS. ENNID XIOMARA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
913 MAIN AVE, PASSAIC, NJ 07055-8540
(973) 458-8000
Mailing address
913 MAIN AVE, PASSAIC, NJ 07055-8540
(973) 458-8000
(973) 458-8425
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA10135200
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2014
Last updated
10/05/2023
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