| Doctor Name: | LEONCIO G GONZALEZ |
| NPI Number: | 1366617987 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 25MA04600100 |
| Business Practice Address: | 400 W Blackwell St St Clares Hospital Dover, NJ - 07801 |
| Business Phone Number: | 9739276519 |
| Business Fax Number: | |
| Mailing Address: | 91 Pleasant Hill Rd, RANDOLPH |
| State: | NJ |
| Postal Code: | 07869 |
| Phone Number: | 9739276519 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2008 |
| NPI Last Update Date: | 04/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 25MA04600100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |