Individual
JOHANNA GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-2800
Mailing address
16324 16TH AVE, WHITESTONE, NY 11357-3328
(718) 640-5560
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F430606-1
NY
Other
Enumeration date
09/01/2011
Last updated
03/09/2016
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