Individual
RAFAEL GONZALEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2038 CENTRAL AVE, ALBANY, NY 12205-4430
(518) 424-4987
(518) 977-3300
Mailing address
2038 CENTRAL AVE, ALBANY, NY 12205-4430
(518) 424-4987
(518) 977-3300
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
100777358
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04098880
—
NY
Enumeration date
11/30/2016
Last updated
11/30/2016
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