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Individual

DR. CARLOS MANUEL GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4107 76TH ST, ELMHURST, NY 11373-1929
(718) 803-3201
(718) 803-0085
Mailing address
4107 76TH ST, ELMHURST, NY 11373-1929
(718) 803-3201
(718) 803-0085

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
156591
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00156591
METROPLUS
NY
05
00834244
NY
01
0402872
UNITED HEALTHCARE
NY
01
040426018611
FIDELIS
NY
01
113394561
1199
NY
01
149808
WELLCARE
NY
01
15659101
NEIGHBORHOOD
NY
01
156591A29
HEALTHFIRST
NY
01
21D17
EMPIRE BC/BS
NY
01
287760101
HEALTHPLUS
NY
01
4C3877
HEALTHNET
NY
01
AS74100570001
CIGNA
NY
01
OH345P
HIP
NY
01
P00156591
OXFORD
NY
01
QN0029702
AMERICHOICE
NY
Enumeration date
08/14/2006
Last updated
01/06/2012
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