Agapito Pete Gonzales
Individual provider Active NPI Counselor · Albuquerque, NJ
NPI 1881901692 · NPPES record last updated Sep 1, 2010
Key facts
- NPI
- 1881901692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- GONNZAP1760S (WA)
- Practice address
- 4401 Morris St NE Apt 288
Albuquerque, NJ 87111 - Phone
- (509) 431-3699
- NPI assigned
- Sep 1, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GONNZAP1760S | WA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | GONNZAP1760S | WA | Yes |
Addresses
Primary practice location
4401 Morris St NE Apt 288
Albuquerque, NJ 87111
Mailing address
4401 Morris St NE Apt 288
Albuquerque, NM 87111-3728
Phone (509) 431-3699
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2010. 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.