Individual
JENNIFER GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6662
Mailing address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6662
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
698967
NY
208000000X
Pediatrics Physician
383233
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383233
NY
Other
Enumeration date
06/15/2021
Last updated
04/29/2026
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