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NPI Code Detail

MEDICARE: ALEX GOMETZ DPT

MEDICARE:   ALEX  GOMETZ  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical Therapist018149-1NY

General Provider Information

NPI Number : 1457441370
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX GOMETZ DPT
Provider Business Mailing Address
First Line : 215 E 73RD ST
Second Line : SUITE 1B
City : NEW YORK
State : NY
Zip : 10021-3653
Country : US
Telephone Number : 212-717-8330
Fax Number : 212-717-6235
Provider Business Practice Location Address
First Line : 215 E 73RD ST
Second Line : SUITE 1B
City : NEW YORK
State : NY
Zip : 10021-3653
Country : US
Telephone Number : 212-717-8330
Fax Number : 212-717-6235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 10/05/2020

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