Healthcare Provider Details

I. General information

NPI: 1386581130
Provider Name (Legal Business Name): PEDRO JESUS GOMEZ ARIAS MD JD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

400 E 52ND ST APT 10A
NEW YORK NY
10022-8755
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5290
  • Fax:
Mailing address:
  • Phone: 787-231-0011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number337149
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: