person
Ian Jerome Gonzales, REEGT,CLTM,CNIM
EEG Specialist/Technologist in Englewood, New Jersey
NPI 1992402119

Ian Jerome Gonzales is a EEG Specialist/Technologist based in Englewood, NJ and is specialized in EEG. Ian Jerome Gonzales practices in Englewood, NJ and has the professional credentials of REEGT,CLTM,CNIM. The NPI Number for Ian Jerome Gonzales is 1992402119 and holds a License No. 4926 (New Jersey).

The current practice location address for Ian Jerome Gonzales is 161 Knickerbocker Rd Apt D, Englewood, NJ and can be reached out via phone at 973-752-9580. You can also correspond with Ian Jerome Gonzales through the mailing address at 161 KNICKERBOCKER RD, ENGLEWOOD, NJ - 07631-2161 (mailing address contact number: 973-752-9580).

Location: 161 Knickerbocker Rd Apt D, Englewood, NJ, 07631-2161
person
Provider Profile Details
NPI Number
1992402119
Provider Name
Ian Jerome Gonzales
Credential
REEGT,CLTM,CNIM
Provider Entity Type
Individual
Gender
Male
Address
161 Knickerbocker Rd Apt D, Englewood, NJ, 07631-2161
Phone Number
973-752-9580
Fax Number
Provider Enumeration Date
02/08/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
161 Knickerbocker Rd Apt D
City
State
Zip
07631-2156
Phone Number
973-752-9580
Fax Number
person
Provider Business Mailing Address Details
Address
161 Knickerbocker Rd
City
State
Zip
07631-2161
Phone Number
973-752-9580
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist, Other
Speciality
EEG
Taxonomy
License No.
456 (New Jersey)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist, Other
Speciality
Electroneurodiagnostic
Taxonomy
License No.
4926 (New Jersey)
Definition
Definition to come...
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