Healthcare Provider Details

I. General information

NPI: 1205831807
Provider Name (Legal Business Name): ERIC ARVIND GOMES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 PRINCETON PIKE
LAWRENCEVILLE NJ
08648-2300
US

IV. Provider business mailing address

3100 PRINCETON PIKE BLDG 3, 3RD FLOOR
LAWRENCEVILLE NJ
08648-2300
US

V. Phone/Fax

Practice location:
  • Phone: 609-896-1793
  • Fax:
Mailing address:
  • Phone: 609-896-1793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA069021
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: