Individual
PETER G. GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2315 ROUTE 34, SUITE D, MANASQUAN, NJ 08736-1444
(732) 974-0404
(732) 974-2653
Mailing address
2315 ROUTE 34, SUITE D, MANASQUAN, NJ 08736-1444
(732) 974-0404
(732) 974-2653
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101246363
VA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
0101246363
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-017
TRICARE/CHAMPUS
VA
01
—
10053837
OPTIMA HEALTH
VA
01
—
1790878148
UNITED HEALTHCARE
VA
05
—
1790878148
—
VA
01
—
388453
ANTHEM BC/BS
VA
05
—
5913812
—
NC
01
—
PAR
AETNA
VA
Enumeration date
09/30/2006
Last updated
05/06/2014
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