Antonio M Gonzales, MD
Individual provider Active NPI Ophthalmology Physician · Closter, NJ
NPI 1801980313 · NPPES record last updated Sep 27, 2012
Key facts
- NPI
- 1801980313
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 125076 (NY)
- Practice address
- 52 Ryerson PL
Closter, NJ 07624-2506 - Phone
- (201) 768-8453
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125076 | NY | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Ophthalmology | Past | Accepting new patients |
| Trustees of Columbia University in the City of New York | Ophthalmology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 125076 | NY | Yes |
Addresses
Primary practice location
52 Ryerson PL
Closter, NJ 07624-2506
Mailing address
52 Ryerson PL
Closter, NJ 07624-2506
Phone (212) 768-8453
Other providers in Closter, NJ
- Marianne Flores
- Carl Joseph Garcia
- Adriana V Gianetti
- Carolina Gomez
- Jeremy Gongola
- Great Atlantic & Pacific Tea Company Inc
- Grossman F & a PC
- Lauren Dara Grossman
- Khalid Hameed
- Kate Hamilton
All providers in Closter, NJ · Ophthalmology Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.