Most Relevant Information
Provider Data
| NPI Number: | 1003428228 |
| Provider Name: | PEDRO MARIO GONZALEZ MS, CTRS |
| Entity Type: | Individual |
| Taxonomy Code: | 225800000X |
| Specialty: | Recreation Therapist |
| License Number: | 13152 |
Most Important Dates
| Enumeration Date: | 08/19/2020 |
| Last Updated: | 08/19/2020 |
Provider Practice Location
2094 ALBANY POST RD
MONTROSE
NY
105481454
Practice Location Phone/Fax
| Phone: | 9147374400 |
| Fax: |
Provider Mailing Location
703 SWAN HOLLOW RD
MONROE
NY
109505108
Provider Mailing Phone/Fax
| Phone: | 5165283222 |
| Fax: |