Organization
FERMIN P GONZALEZ MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FERMIN P GONZALEZ MD (DOCTOR)
(718) 898-5200
Entity
Organization
Contact information
Practice address
102-11 ROOSEVELT AVE, CORONA, NY 11368-2331
(718) 898-5200
(718) 898-3673
Mailing address
102-11 ROOSEVELT AVE, CORONA, NY 11368-2331
(718) 898-5200
(718) 898-3673
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
205495
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205495
LICENSE
NY
Enumeration date
07/10/2007
Last updated
03/17/2017
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