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General NPI Number Information
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NPI Number | 1497825129
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Entity Type | Individual
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Provider Name | MERY CONCEPCION GOMEZ M.D., MPH
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 11835 QUEENS BLVD STE 400
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City | FOREST HILLS
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State | NY
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Zip | 11375-7211
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Country | US
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Telephone | 646-722-7610
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Fax |
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Provider Business Mailing Address
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Address Line | 1371 SEABURY AVE
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City | BRONX
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State | NY
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Zip | 10461-3651
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Country | US
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Telephone | 718-583-7736
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 218769
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License Number State | NY
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