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Individual
MRS. IRENE GOMEZ
Active
Individual
MRS. IRENE GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
014177
NY
Other
Enumeration date
09/26/2010
Last updated
10/15/2010
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