Angie Gomez

Primary specialty

OpticianTaxonomy code 156FX1800X

License

31TD00404400 Issued in NJ

Practice address

400 Park PL
Secaucus, NJ 07094-3654

Phone

(201) 325-9277

Fax

(201) 325-9347

NPI assigned

May 24, 2023

Last updated

May 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1013609379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PARK PL",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943654",
            "telephone_number": "201-325-9277",
            "fax_number": "201-325-9347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARK PL",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943654",
            "telephone_number": "201-325-9277",
            "fax_number": "201-325-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ANGIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": "31TD00404400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in Secaucus, NJ
• Providers in Secaucus, NJ by specialty
• Optician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.