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NPI Code Detail

MEDICARE: DR. MARCO ANTONIO GOMEZ PSYD

MEDICARE: DR. MARCO ANTONIO GOMEZ PSYD
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
1103T00000XPsychologistPSY10000078MA

General Provider Information

NPI Number : 1790234466
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCO ANTONIO GOMEZ PSYD
Provider Business Mailing Address
First Line : 5 WEST ST APT 5
Second Line :
City : EASTHAMPTON
State : MA
Zip : 01027-1325
Country : US
Telephone Number : 925-470-0720
Fax Number :
Provider Business Practice Location Address
First Line : 50 PLEASANT ST
Second Line :
City : NORTHAMPTON
State : MA
Zip : 01060-4127
Country : US
Telephone Number : 413-584-6855
Fax Number : 413-585-1355
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2016
Last Update Date : 12/08/2025

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