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NPI Code Detail

MEDICARE: DR. JOSE ALEJANDRO GOMEZ O.D.

MEDICARE: DR. JOSE ALEJANDRO GOMEZ O.D.
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
1152W00000XOptometristVUT6417NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A01762OTHERNYEYEMED
2P4065567OTHERNYOXFORD HEALTH
3T006417OTHERNYMETROPLUS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5968NOTHERNYNATIONAL OPTICAL SERVICES
67184761458OTHERNYVSP
73101578OTHERNYUNITED HEALTHCARE

General Provider Information

NPI Number : 1588737977
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE ALEJANDRO GOMEZ O.D.
Provider Business Mailing Address
First Line : 186 CORNWELL AVE
Second Line :
City : WILLISTON PARK
State : NY
Zip : 11596-1048
Country : US
Telephone Number : 516-998-0123
Fax Number : 212-569-3166
Provider Business Practice Location Address
First Line : 7508 37TH AVE
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-6538
Country : US
Telephone Number : 718-476-1458
Fax Number : 718-476-1462
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 03/30/2010

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