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Provider Information for 1447333075

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALEJANDRO GOMEZ MD

Gender: MALE

Individual NPI: 1447333075

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1447333075
Enumeration Date 2006-10-24
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 11 SHIRLEY ANN DR
OCEAN, NJ 07712-3229
United States

Phone: 732-922-8543 | Fax: 732-758-0866
View Map External Link
Primary Practice Address 776 SHREWSBURY AVE SUITE 103
TINTON FALLS, NJ 07724-3006
United States

Phone: 732-758-1223 | Fax: 732-758-0866
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NJ 8846502
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208000000X - Pediatrics NJ 25MA07362100