Gonzalez, John

Gonzalez, John is an individual health care provider with primary practice located at 7 Sun Valley Ct , Northport NY 11768-2137. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Gonzalez, John can be contacted via phone (631) 261-4124.

Contact Information

Primary practice address
7 Sun Valley Ct Northport NY 11768-2137
Phone: (631) 261-4124
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 39968 New York

Profile Details

NPI number 1083755730
LBN Legal business name Gonzalez, John
Credentials Bachelor of Science in Public Health (BSPH)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083755730 NPPES
New York MEDICAID 00396745

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