Lori Gonzalo, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

009282 Issued in NY

Practice address

2071 Clove Rd
Grasmere Medical Pavillion
Staten Island, NY 10304-1671

Phone

(718) 442-5550

Fax

(718) 556-3025

NPI assigned

Mar 21, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1639294002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 EMILY CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103072087",
            "telephone_number": "718-966-1784",
            "fax_number": "718-966-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 CLOVE RD",
            "address_2": "GRASMERE MEDICAL PAVILLION",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041671",
            "telephone_number": "718-442-5550",
            "fax_number": "718-556-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALO",
        "first_name": "LORI",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lyn Gonzalez, P.T.
• Rebecca Rose Gonzalez
• Rosaura Gonzalez, L.AC.
• Victoria Maria Gonzalez, PTA
• Caitlin Gonzalo, MS, RN, FNP-BC
• Good Care PT PC
• Good Faith Adult Day Care Inc
• Good Faith Social Daycare
• Good Life Advancement and Development Inc
• Good Looking Optical Corp

• Medical Physician Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.