Individual
PHIL GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6214 24TH AVE, BROOKLYN, NY 11204-3319
(866) 222-1111
Mailing address
283 FALMOUTH AVE APT B, ELMWOOD PARK, NJ 07407-2809
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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