Provider Demographics
NPI:1003528696
Name:GOMOLINSKI, RITA EVE
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:EVE
Last Name:GOMOLINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SOUTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-8602
Mailing Address - Country:US
Mailing Address - Phone:201-835-0168
Mailing Address - Fax:
Practice Address - Street 1:150 N QUEEN ST STE 517
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-6226
Practice Address - Country:US
Practice Address - Phone:717-399-7323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor