Provider Demographics
NPI:1164503215
Name:GONZALEZ, NATHALY NYREE (HEALTH SERVICE TECH)
Entity Type:Individual
Prefix:MRS
First Name:NATHALY
Middle Name:NYREE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:HEALTH SERVICE TECH
Other - Prefix:MRS
Other - First Name:NATHALIA
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:400 SAND ISLAND ACCESS ROAD
Mailing Address - Street 2:USCG ISC HONOLULU
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819
Mailing Address - Country:US
Mailing Address - Phone:808-842-2930
Mailing Address - Fax:808-842-2956
Practice Address - Street 1:400 SAND ISLAND ACCESS ROAD
Practice Address - Street 2:USCG ISC HONOLULU
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819
Practice Address - Country:US
Practice Address - Phone:808-842-2930
Practice Address - Fax:808-842-2956
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other