Individual
DR. RICARDO ANTONIO GOMEZ-VASQUEZ.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 MOUNT PROSPECT AVE, NEWARK, NJ 07104-1530
(973) 482-4697
(973) 482-0893
Mailing address
520 N WOOD AVE, LINDEN, NJ 07036-4147
(908) 587-9300
(908) 587-1901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA09202200
NJ
207Q00000X
Family Medicine Physician
267260
NY
207Q00000X
Family Medicine Physician
N7265
TX
207R00000X
Internal Medicine Physician
48241
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0331651
—
NJ
01
—
25MA09202200
NJ MEDICAL LICENSE
NJ
01
—
267260
NEW YORK MEDICAL LICENSE
NY
01
—
48241
CONNECTICUT MEDICAL LICENCE
CT
01
—
N7265
TEXAS MEDICAL LICENSE
TX
Enumeration date
05/19/2008
Last updated
05/04/2020
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