Individual
MITHRA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 273-3937
Mailing address
601 ELMWOOD AVE, BOX 659, ROCHESTER, NY 14642-0001
(585) 273-3937
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
266016
NY
207W00000X
Ophthalmology Physician
48791
CO
207WX0109X
Neuro-ophthalmology Physician
266016
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36971383
—
CO
Enumeration date
08/17/2006
Last updated
07/06/2023
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