Individual
RICHARD GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1444 5TH AVE, BAY SHORE, NY 11706-4147
(631) 647-3100
Mailing address
9 KIRK RD, BAY SHORE, NY 11706-1613
(631) 553-3577
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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