Individual
JENNY GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
455 45TH ST, COPIAGUE, NY 11726-1018
(718) 762-7633
Mailing address
455 45TH ST, COPIAGUE, NY 11726-1018
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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