Active NPI
Paola Gonzalez
- Clinical Social Worker
- Bay Shore, NY
National Provider Identifier
1386136232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 088353-1
- Practice address
- 75 Perkal St
Bay Shore, NY 11706-6642 - Phone
- (631) 968-1100
- NPI assigned
- Jun 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 084548 | NY | |
| Clinical Social Worker | 1041C0700X | 088353-1 | NY | Primary |
Addresses
Primary practice location
75 Perkal St
Bay Shore, NY 11706-6642
Mailing address
1444 5TH Ave
Bay Shore, NY 11706-4147
Other practice location 1
1444 5th Ave
Bay Shore, NY 11706-4147
Phone (631) 650-0110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 084548 | NY | MD | Social Worker |
| 088353-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1386136232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1444 5TH AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117064147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 PERKAL ST",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117066642",
"telephone_number": "631-968-1100"
}
],
"practiceLocations": [
{
"address_1": "1444 5th Ave",
"address_purpose": "LOCATION",
"city": "Bay Shore",
"state": "NY",
"postal_code": "117064147",
"country_code": "US",
"telephone_number": "631-650-0110",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALEZ",
"first_name": "PAOLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-05",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "084548",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "088353-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.