Provider Demographics
NPI:1457510844
Name:GONZALEZ-LOMAS, GUILLEM (MD)
Entity Type:Individual
Prefix:
First Name:GUILLEM
Middle Name:
Last Name:GONZALEZ-LOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2772
Mailing Address - Country:US
Mailing Address - Phone:212-598-6115
Mailing Address - Fax:212-598-6727
Practice Address - Street 1:333 E 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2772
Practice Address - Country:US
Practice Address - Phone:212-598-6115
Practice Address - Fax:212-598-6727
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102934207XX0005X
NJ25MA08727600207XX0005X
NY267190207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine