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NPI Code Detail

MEDICARE: CARLO AUGUSTIN GOMEZ CLORIBEL PT

MEDICARE: CARLO AUGUSTIN GOMEZ CLORIBEL PT
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
1225100000XPhysical Therapist027592NY

General Provider Information

NPI Number : 1982859609
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLO AUGUSTIN GOMEZ CLORIBEL PT
Provider Business Mailing Address
First Line : 2199 HOLLAND AVE APT 2J
Second Line :
City : BRONX
State : NY
Zip : 10462-1760
Country : US
Telephone Number : 134-774-9255
Fax Number :
Provider Business Practice Location Address
First Line : 500 19TH ST FL 3
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-6204
Country : US
Telephone Number : 718-237-8833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2008
Last Update Date : 06/22/2021

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