Individual
MICHAEL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS., LAT
Contact information
Practice address
1983 MARCUS AVE, NEW HYDE PARK, NY 11042-2000
(516) 321-7804
Mailing address
16 BELLA VISTA AVE, GLEN COVE, NY 11542-3706
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
67003009
NY
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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