Delia Gonzalez

Individual provider Active NPI Registered Nurse · Henryville, PA

NPI 1184968331 · NPPES record last updated Nov 11, 2012

Key facts

NPI
1184968331
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
489628 (NY)
Practice address
3079 Route 715
Henryville, PA 18332-7778
Phone
(570) 699-9399
NPI assigned
Nov 11, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
489628NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 489628 NY Yes

Addresses

Primary practice location

3079 Route 715
Henryville, PA 18332-7778

Mailing address

3079 Route 715
Henryville, PA 18332-7778
Phone (570) 699-9399

Other providers in Henryville, PA

All providers in Henryville, PA · Registered Nurse in Pennsylvania

Sources for this page

Verify at the official NPI Registry.