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MR. LUIS MICHEAL GOMEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
313 W 143RD ST, 1A, NEW YORK, NY 10030-1203
(646) 773-3832
Mailing address
313 W 143RD ST, 1A, NEW YORK, NY 10030-1203
(646) 773-3832

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
003940-1
NY

Other

Enumeration date
11/05/2007
Last updated
11/05/2007
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