Randy M Gonzales, L.AC,LMT

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

005079-1 Issued in NY

Practice address

999 Old Medford Ave
Farmingville, NY 11738-2829

Phone

(631) 875-7200

NPI assigned

Jul 15, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Randy M Gonzales Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1972944312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 OLD MEDFORD AVE",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117382829",
            "telephone_number": "631-875-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 OLD MEDFORD AVE",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117382829",
            "telephone_number": "631-875-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "RANDY",
        "middle_name": "M",
        "credential": "L.AC,LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-15",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "005079-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDY",
            "last_name": "GONZALES",
            "middle_name": "M",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Acupuncturist in Farmingville, NY
• Providers in Farmingville, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; 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.