Provider Demographics
NPI:1598709107
Name:GOMEZ, FRANCES (MD)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-2111
Mailing Address - Country:US
Mailing Address - Phone:201-394-1238
Mailing Address - Fax:
Practice Address - Street 1:282 E RTE 4
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5101
Practice Address - Country:US
Practice Address - Phone:551-222-0800
Practice Address - Fax:551-222-0801
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172186207P00000X
NJ25MA05246600207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE53590Medicare UPIN
NJ588663Medicare PIN