Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 19793 | NH |
N | 207RG0100X | Gastroenterologist | MD193907 | OR |
NPI | 1023014958 |
---|---|
Provider Name | Irma Cruz-Gonzalez |
First Address | Amesbury, MA 01913-3530 |
Second Address | Newburyport, MA 01950-3596 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 03/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110160860A | (05) | MA |
269186800 | (05) | FL |
I19432 | (02) | FL |