Individual
ABEL A GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2299 BRODHEAD RD, SUITE N, BETHLEHEM, PA 18020-8908
(610) 882-2052
(610) 882-2054
Mailing address
2299 BRODHEAD RD, BETHLEHEM, PA 18020-8908
(610) 882-2052
(610) 882-2054
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
MD041390E
PA
103TP0016X
Prescribing (Medical) Psychologist
MD041390E
PA
2084P0800X
Psychiatry Physician
Primary
MD041390E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011766350001
—
PA
01
—
01950901
CAPITAL BLUE CROSS
PA
01
—
596171
HIGHMARK BLUE SHIELD
PA
01
—
P853356
OXFORD HEALTH PLAN
PA
Enumeration date
06/14/2006
Last updated
07/24/2020
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