Provider Demographics
NPI:1003974387
Name:GONZALEZ, MONICA (DC)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3607
Mailing Address - Country:US
Mailing Address - Phone:908-469-4070
Mailing Address - Fax:908-469-4068
Practice Address - Street 1:278 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3607
Practice Address - Country:US
Practice Address - Phone:908-469-4070
Practice Address - Fax:908-469-4068
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4791111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01000570400Medicaid
NJ01000570400Medicaid
NJU63193Medicare UPIN