Provider Demographics
NPI:1447789805
Name:GONCALVES, ALEC JAMES (ATC)
Entity Type:Individual
Prefix:MR
First Name:ALEC
Middle Name:JAMES
Last Name:GONCALVES
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31 GREEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:GOLDENS BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10526-1015
Mailing Address - Country:US
Mailing Address - Phone:914-483-8792
Mailing Address - Fax:
Practice Address - Street 1:31 GREEN HILL ROAD
Practice Address - Street 2:
Practice Address - City:GOLDENS BRIDGE
Practice Address - State:NY
Practice Address - Zip Code:10526
Practice Address - Country:US
Practice Address - Phone:914-483-8792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer