Subramani Gonzalez, Shivanna

Subramani Gonzalez, Shivanna is an sole proprietor health care provider with primary practice located at 504 Wolcott Rd , Wolcott CT 06716-2461. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Subramani Gonzalez, Shivanna can be contacted via phone (203) 725-5339.

Contact Information

Primary practice address
504 Wolcott Rd Wolcott CT 06716-2461
Phone: (203) 725-5339
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5993 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 5993 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 009553 Connecticut

Profile Details

NPI number 1457758179
LBN Legal business name Subramani Gonzalez, Shivanna
Credentials DNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 24th, 2014
Last updated May 12th, 2023 - about 2 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 1457758179 NPPES
Connecticut Other 005993 STATE LICENSE

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