Active NPI
Juan A Gomez, MS. SP. TEACHER
- Contractor
- Bronx, NY
National Provider Identifier
1730315946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 17
- Practice address
- 1575 Allerton Ave
Bronx, NY 10469-6132 - Phone
- (347) 879-7513
- Fax
- (347) 879-7513
- NPI assigned
- Jun 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 17 | NY | Primary |
Addresses
Primary practice location
1575 Allerton Ave
Bronx, NY 10469-6132
Mailing address
1575 Allerton Ave
Bronx, NY 10469-6132
Phone (347) 879-7513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17 | NY | MD | Early Intervention Provider Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243900800000",
"number": "1730315946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 ALLERTON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104696132",
"telephone_number": "347-879-7513",
"fax_number": "347-879-7513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 ALLERTON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104696132",
"telephone_number": "347-879-7513",
"fax_number": "347-879-7513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "JUAN",
"middle_name": "A",
"credential": "MS. SP. TEACHER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-02",
"last_updated": "2009-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NY",
"license": "17",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.