1346305463 NPI number — DR. CRISTINA GOMEZ DE NERY M.D.

Table of content: DR. CRISTINA GOMEZ DE NERY M.D. (NPI 1346305463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346305463 NPI number — DR. CRISTINA GOMEZ DE NERY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOMEZ DE NERY
Provider First Name:
CRISTINA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NERY
Provider Other First Name:
CRISTINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1346305463
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 364747
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00936-4747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-759-7822
Provider Business Mailing Address Fax Number:
787-759-8887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CONDOMINIO EL CENTRO II LOCAL 21
Provider Second Line Business Practice Location Address:
AVE. MUNOZ RIVERA 500
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-759-7822
Provider Business Practice Location Address Fax Number:
787-759-8887
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0101X , with the licence number:  4986 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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