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Individual

DR. LUIS A. GONZALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
781 EAST 142ND STREET, BRONX, NY 10454-1723
(718) 918-3060
(718) 918-4469
Mailing address
781 EAST 142ND STREET, BRONX, NY 10454-1723
(718) 993-1400
(718) 993-0647

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
190284
NY
2084P0804X
Child & Adolescent Psychiatry Physician
190284-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01847103
NY
Enumeration date
11/02/2006
Last updated
02/26/2010
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