Provider Information for 1386303857
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GIANNY GOMEZ-MADERA
Other Names:Former Name:GIANNY GOMEZSex: Female
NPI: 1386303857
Last Updated: 2024-12-23
Certification Date: 2024-12-23
Certification Date: 2024-12-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1386303857 | ||||||||
| Enumeration Date | 2021-12-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 362 CHESTNUT CT APT 1 BROOKLYN, NY 11208-2658 United States Phone: 347-678-9136 | Fax: | ||||||||
| Primary Practice Address | 2552 PITKIN AVE STE 3 #1016 BROOKLYN, NY 11208 United States Phone: 347-678-9136 | Fax: | ||||||||
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