Provider Demographics
NPI:1407080062
Name:GONZALEZ, ALAINA N (CMT)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:N
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 RIDGE TER
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6614
Mailing Address - Country:US
Mailing Address - Phone:732-403-6853
Mailing Address - Fax:
Practice Address - Street 1:68 RIDGE TER
Practice Address - Street 2:
Practice Address - City:NEPTUNE CITY
Practice Address - State:NJ
Practice Address - Zip Code:07753-6614
Practice Address - Country:US
Practice Address - Phone:732-403-6853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor