Individual
MR. ADAM K GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
2800 MARCUS AVE, LAKE SUCCESS, NY 11042
(516) 622-7485
Mailing address
2800 MARCUS AVE, LAKE SUCCESS, NY 11042
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
013139
NY
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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