Individual
ELISHA GRACE GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6915 YELLOWSTONE BLVD STE 4, FOREST HILLS, NY 11375-3787
(718) 360-9550
Mailing address
6915 YELLOWSTONE BLVD, FOREST HILLS, NY 11375-9406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
027161
NY
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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