Provider Demographics
NPI:1497355580
Name:GOMEZ, FRANCISCO ANTONIO (LMT)
Entity Type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:ANTONIO
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 HOES LN STE 200
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4143
Mailing Address - Country:US
Mailing Address - Phone:732-877-4534
Mailing Address - Fax:
Practice Address - Street 1:371 HOES LN STE 200
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4143
Practice Address - Country:US
Practice Address - Phone:732-877-4534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT01221900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist