Individual
FERNANDO GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 MALTESE DR, MIDDLETOWN, NY 10940-2115
(845) 342-4774
(845) 343-8741
Mailing address
111 MALTESE DR, MIDDLETOWN, NY 10940-2115
(845) 342-4774
(845) 343-8741
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
263083
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A400057668
MEDICARE
NY
Enumeration date
04/14/2010
Last updated
12/27/2011
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