Individual
DR. IVAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
18710 LINDEN BLVD, SAINT ALBANS, NY 11412-4026
(718) 723-1769
Mailing address
351 E 85TH ST, 4A, NEW YORK, NY 10028-4556
(212) 734-9013
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N005253
NY
Other
Enumeration date
01/20/2006
Last updated
11/10/2010
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