Individual
DR. MARY THERESA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
128 N LINCOLN AVE, NEWTOWN, PA 18940-2214
(215) 860-0629
(215) 860-0629
Mailing address
128 N LINCOLN AVE, NEWTOWN, PA 18940-2214
(215) 860-0629
(215) 860-0629
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN256859L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-07571
EVERCARE
—
01
—
GO509036
HORIZON BLUE SHIELD
—
Enumeration date
12/11/2007
Last updated
03/30/2021
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