Individual
DR. CARLOS ALFONSO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
317 NORTH MAIN STREET, C/O CCGC, MANCHESTER, CT 06042
(860) 643-2101
(860) 645-1470
Mailing address
345 HIGHLAND AVE, CHESHIRE, CT 06410-2550
(203) 272-3055
(203) 272-3303
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
029950
CT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
029950
CT
Other
Enumeration date
02/09/2007
Last updated
10/12/2012
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