Organization
KALEIDOSCOPE MEDICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANA P GOMES D.O., CMD (PRESIDENT)
(908) 454-9902
Entity
Organization
Contact information
Practice address
410 COVENTRY DR, PHILLIPSBURG, NJ 08865-1978
(908) 454-9902
(908) 454-9905
Mailing address
410 COVENTRY CENTRE DR., PHILLIPSBURG, NJ 08865
(908) 454-9902
(908) 454-9902
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA06829400
NJ
207Q00000X
Family Medicine Physician
25MB077888000
NJ
207Q00000X
Family Medicine Physician
Primary
MB064321
NJ
207Q00000X
Family Medicine Physician
MB065920
NJ
363L00000X
Nurse Practitioner
NN095449NJ
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057908
—
NJ
01
—
041113
MEDICARE NJ
NJ
01
—
119772
MEDICARE PA
PA
05
—
7387601
—
NJ
05
—
7437307
—
NJ
05
—
8313407
—
NJ
05
—
8440506
—
NJ
Enumeration date
06/23/2006
Last updated
02/08/2008
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