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NPI Code Detail

MEDICARE: ROSANNA GOMEZ

MEDICARE:   ROSANNA  GOMEZ
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1912325234
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSANNA GOMEZ
Provider Business Mailing Address
First Line : 610 ACADEMY ST
Second Line : APT. A2
City : NEW YORK
State : NY
Zip : 10034-5058
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 610 ACADEMY ST
Second Line : APT. A2
City : NEW YORK
State : NY
Zip : 10034-5058
Country : US
Telephone Number : 718-239-8239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2014
Last Update Date : 04/03/2014

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Directions to “ ROSANNA GOMEZ ” Practice Location

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