Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WILSON GONZALEZ
Active Sole ProprietorWILSON GONZALEZ is a Van Provider healthcare provider located in LAKE RONKONKOMA, New York. NPI 1740716745 is currently active in the NPPES registry. Verify at CMS.
Van Provider · LAKE RONKONKOMA, NY
Registration Details
- NPI Number
- 1740716745
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 11, 2017 (9.273940712735 yrs)
- Last Updated
- May 11, 2017
- Licenses
-
756867726 (NY)5700567 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2 FERN DRLAKE RONKONKOMA, NY, 117794505Browse NY providers · Browse ZIP 11779
- Phone
- 6315729585
- Primary Specialty
-
Van Provider
344600000X
- Additional Specialty
- Van Provider
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.