Provider Demographics
NPI:1912520735
Name:GONZALEZ, HILAURY (MSW)
Entity Type:Individual
Prefix:
First Name:HILAURY
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 5TH AVE # A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3119
Mailing Address - Country:US
Mailing Address - Phone:212-426-3400
Mailing Address - Fax:
Practice Address - Street 1:1475 PARK AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3119
Practice Address - Country:US
Practice Address - Phone:212-426-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112450104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1912520735OtherMSW NPI