Individual
MAUREEN GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., C.S.O., C.D.N.
Contact information
Practice address
5091 AMBOY RD, STATEN ISLAND, NY 10312-4722
(718) 984-2100
(718) 317-6582
Mailing address
792 BLOOMINGDALE RD, STATEN ISLAND, NY 10309-1604
(718) 948-3092
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
002846-1
NY
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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