| Doctor Name: | DIANA M GOMEZ |
| NPI Number: | 1043669880 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | F340585 |
| Business Practice Address: | 136 Knickerbocker Ave Paterson, NJ - 075031325 |
| Business Phone Number: | 9739195975 |
| Business Fax Number: | |
| Mailing Address: | 136 Knickerbocker Ave, PATERSON |
| State: | NJ |
| Postal Code: | 075031325 |
| Phone Number: | 9739195975 |
| Fax Number: | |
| NPI Enumeration Date: | 06/11/2016 |
| NPI Last Update Date: | 06/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F340585 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |