Healthcare Provider Details
I. General information
NPI: 1811958366
Provider Name (Legal Business Name): JOHN-PAUL GOMEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/31/2006
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2710 SCHOENERSVILLE RD
BETHLEHEM PA
18017-3574
US
IV. Provider business mailing address
2100 MACK BLVD
ALLENTOWN PA
18103-5622
US
V. Phone/Fax
- Phone: 610-297-7500
- Fax: 610-297-7533
- Phone: 484-884-4500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD423594 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | MD423594 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0015X |
| Taxonomy | Psychosomatic Medicine Physician |
| License Number | 423594 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: