Individual
DIANA GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45-25 48 STREET, APT 3C, WOODSIDE, NY 11377
(646) 894-1157
Mailing address
4525 48TH ST APT 3C, WOODSIDE, NY 11377-5311
(646) 894-1157
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
021922
NY
Other
Enumeration date
09/22/2017
Last updated
07/21/2022
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