Individual
MRS. LORI GONZALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
2071 CLOVE RD, GRASMERE MEDICAL PAVILLION, STATEN ISLAND, NY 10304-1671
(718) 442-5550
(718) 556-3025
Mailing address
20 EMILY CT, STATEN ISLAND, NY 10307-2087
(718) 966-1784
(718) 966-1969
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009282
NY
Other
Enumeration date
03/21/2007
Last updated
04/29/2009
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