Healthcare Provider Details

I. General information

NPI: 1649974791
Provider Name (Legal Business Name): KRISZTINA KUN GOMEZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WASHINGTON CTR STE 2
NEWBURGH NY
12550-4667
US

IV. Provider business mailing address

3 WASHINGTON CTR STE 2
NEWBURGH NY
12550-4667
US

V. Phone/Fax

Practice location:
  • Phone: 845-862-6160
  • Fax: 845-378-3284
Mailing address:
  • Phone: 845-862-6160
  • Fax: 845-378-3284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number082492
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: