Organization
DEPARTMENT OF PHYSICAL MEDICINE AND REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD GONZALEZ MD (AUTHORIZED REPRESENTATIVE, MD)
(609) 734-7600
Entity
Organization
Contact information
Practice address
79 BAYARD LN, PRINCETON, NJ 08540-3045
(609) 734-7600
Mailing address
4 PRINCESS RD, SUITE #207, LAWRENCEVILLE, NJ 08648-2322
(609) 734-7600
(609) 844-1092
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7227604
—
NJ
Enumeration date
05/17/2007
Last updated
01/22/2009
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