Individual
JACLYN GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1203 LANGHORNE NEWTOWN RD, SUITE 225, LANGHORNE, PA 19047-1209
(215) 710-6613
(215) 710-6614
Mailing address
4034 PECHIN ST, PHILADELPHIA, PA 19128-3626
(516) 606-9292
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
MA067379
PA
363A00000X
Physician Assistant
Primary
OA007549
PA
Other
Enumeration date
12/10/2025
Last updated
01/12/2026
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