MEDICARE: ALICIA GOMEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	129405	NY

General Provider Information

NPI Number	:	1417807280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA GOMEZ

Provider Business Mailing Address
First Line	:	1001 WHITLOCK AVE APT 719
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10459-2671
Country	:	US
Telephone Number	:	408-680-6263
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 WHITLOCK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10459-2671
Country	:	US
Telephone Number	:	408-680-6263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “ ALICIA GOMEZ ” Practice Location

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