Provider Demographics
NPI:1932593308
Name:GONZALEZ, KATTY FERNANDA (LPN)
Entity Type:Individual
Prefix:
First Name:KATTY
Middle Name:FERNANDA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MORRIS ST
Mailing Address - Street 2:APT 1W
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1918
Mailing Address - Country:US
Mailing Address - Phone:914-207-9220
Mailing Address - Fax:
Practice Address - Street 1:12 MORRIS ST
Practice Address - Street 2:APT 1W
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-1918
Practice Address - Country:US
Practice Address - Phone:914-207-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health