Provider Demographics
NPI:1568721363
Name:GOMEZ, SILVANA G (MA)
Entity Type:Individual
Prefix:MRS
First Name:SILVANA
Middle Name:G
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 MAGIE AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1573
Mailing Address - Country:US
Mailing Address - Phone:908-265-1735
Mailing Address - Fax:
Practice Address - Street 1:741 MAGIE AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-1573
Practice Address - Country:US
Practice Address - Phone:908-265-1735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor