Provider Demographics
NPI:1578226817
Name:GOMEZ-BRITO, IRIS Y (DNP, CNN)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:Y
Last Name:GOMEZ-BRITO
Suffix:
Gender:F
Credentials:DNP, CNN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 DYER AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1547
Mailing Address - Country:US
Mailing Address - Phone:973-330-2292
Mailing Address - Fax:
Practice Address - Street 1:716 BROAD ST STE 2A
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1645
Practice Address - Country:US
Practice Address - Phone:973-221-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00076801367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty