Healthcare Provider Details

I. General information

NPI: 1013305432
Provider Name (Legal Business Name): CLAUDIO GOMEZ DPM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 US HIGHWAY 22 W UNIT 40 B
NORTH PLAINFIELD NJ
07060-3805
US

IV. Provider business mailing address

120 W 7TH ST SUITE 211
PLAINFIELD NJ
07060-1643
US

V. Phone/Fax

Practice location:
  • Phone: 908-756-5049
  • Fax: 908-271-4496
Mailing address:
  • Phone: 908-755-5500
  • Fax: 908-271-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00298900
License Number StateNJ

VIII. Authorized Official

Name: DR. CLAUDIO GOMEZ
Title or Position: OWNER / DOCTOR
Credential: D.P.M.
Phone: 908-755-5500