Provider Demographics
NPI:1538215900
Name:GONZALEZ, TERESA R (RPA-C)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:R
Last Name:GONZALEZ
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Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:91-1007 WAIILIKAHI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6407
Mailing Address - Country:US
Mailing Address - Phone:917-582-2356
Mailing Address - Fax:808-441-0013
Practice Address - Street 1:1 JARRETT WHITE RD RM 2C156
Practice Address - Street 2:
Practice Address - City:TRIPLER AMC
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-1946
Practice Address - Fax:808-441-0013
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2024-01-29
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Provider Licenses
StateLicense IDTaxonomies
NY009531363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical