Provider Demographics
NPI:1922260348
Name:GONZALEZ-DUARTE, ALEJANDRA
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:GONZALEZ-DUARTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ALEJANDRA
Other - Last Name:GONZALEZ-DUARTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:203 E 27TH ST
Mailing Address - Street 2:AP 43
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9157
Mailing Address - Country:US
Mailing Address - Phone:315-292-1230
Mailing Address - Fax:
Practice Address - Street 1:203 E 27TH ST
Practice Address - Street 2:AP 43
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9157
Practice Address - Country:US
Practice Address - Phone:315-292-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP55257208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice