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Individual

JACOB ALLEN GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PCT, CET, CPT, BLS

Contact information

Practice address
317 WEST AVE, #113197 SMB#82886, STAMFORD, CT 06911
(203) 635-3548
Mailing address
317 WEST AVE, #113197 SMB#82886, STAMFORD, CT 06911
(203) 635-3548

Taxonomy

Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
CT
374700000X
Technician
ELECTROCARDIOGRAM
CT
3747P1801X
Personal Care Attendant
CT
374U00000X
Home Health Aide
CT

Other

Enumeration date
04/17/2025
Last updated
05/20/2025
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