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Individual

RANDY M GONZALES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC,LMT

Contact information

Practice address
999 OLD MEDFORD AVE, FARMINGVILLE, NY 11738-2829
(631) 875-7200
Mailing address
999 OLD MEDFORD AVE, FARMINGVILLE, NY 11738-2829
(631) 875-7200

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005079-1
NY

Other

Enumeration date
07/15/2013
Last updated
06/25/2015
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