Individual
DR. MA. LOURDES C. GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17541 HILLSIDE AVE, JAMAICA, NY 11432-5724
(516) 472-1710
Mailing address
94 VILLAGE AVE, ELMONT, NY 11003-4236
(516) 472-1710
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
243713
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
243713
LICENSE
—
Enumeration date
05/09/2007
Last updated
12/11/2024
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