Provider Demographics
NPI:1346305463
Name:GOMEZ DE NERY, CRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:GOMEZ DE NERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:NERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 364747
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4747
Mailing Address - Country:US
Mailing Address - Phone:787-759-7822
Mailing Address - Fax:787-759-8887
Practice Address - Street 1:CONDOMINIO EL CENTRO II LOCAL 21
Practice Address - Street 2:AVE. MUNOZ RIVERA 500
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-759-7822
Practice Address - Fax:787-759-8887
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4986207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD83332Medicare UPIN