Provider Demographics
NPI:1013234491
Name:GONZALEZ, ALINA A (MS, CDN)
Entity Type:Individual
Prefix:MRS
First Name:ALINA
Middle Name:A
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 FALLER DR APT C
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-5203
Mailing Address - Country:US
Mailing Address - Phone:201-261-6315
Mailing Address - Fax:
Practice Address - Street 1:310 FALLER DR APT C
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-5203
Practice Address - Country:US
Practice Address - Phone:201-261-6315
Practice Address - Fax:201-261-6315
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02079-1133NN1002X
NY002079-1133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education