Organization
FORT WASHINGTON MEDICAL OFFICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAUSTO A GONZALEZ MD (PARTNER/OWNER)
(212) 927-0013
Entity
Organization
Contact information
Practice address
65 FORT WASHINGTON AVE, NEW YORK, NY 10032-4634
(212) 927-0013
(212) 927-0014
Mailing address
65 FORT WASHINGTON AVE, NEW YORK, NY 10032-4634
(212) 927-0013
(212) 927-0014
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03288346
—
NY
Enumeration date
06/15/2006
Last updated
06/13/2023
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