Basic Information
Provider Information
NPI: 1700835386
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GONZALEZ-AVILES
FirstName: ARNALDO
MiddleName:  
NamePrefix:  
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Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 423 E 23RD ST
Address2: NY HARBOR HEALTH CARE SYSTEM, MANHATTAN CAMPUS
City: NEW YORK
State: NY
PostalCode: 100105011
CountryCode: US
TelephoneNumber: 2126867500
FaxNumber:  
Practice Location
Address1: 423 E 23RD ST
Address2: VA NY HARBOR HEALTH CARE SYSTEM
City: NEW YORK
State: NY
PostalCode: 100105011
CountryCode: US
TelephoneNumber: 2126867500
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/09/2006
LastUpdateDate: 07/17/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X173950NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0802X173950NYN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
2084P0805X173950NYN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry

No ID Information.


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