Individual provider · Type 1 NPI

Lori Gonzalo, RPA-C

Medical Physician Assistant · Staten Island, NY

NPI number 1639294002 Active

Practice location

2071 Clove Rd, Grasmere Medical Pavillion
Staten Island, NY 10304-1671

Call (718) 442-5550 Map

Fax (718) 556-3025

Mailing address

20 Emily Ct
Staten Island, NY 10307-2087

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X009282 (NY)

Medical Physician Assistant: Definition to come...

10 other providers at this address

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About NPI 1639294002

Lori Gonzalo, RPA-C's National Provider Identifier is 1639294002, issued on Mar 21, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Staten Island, NY. The record was last updated on Apr 29, 2009.