Provider Demographics
NPI:1730498171
Name:GOMES, ELIZABETH M (DO)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:GOMES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 EAST AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5299
Mailing Address - Country:US
Mailing Address - Phone:401-727-4800
Mailing Address - Fax:
Practice Address - Street 1:407 EAST AVE STE 150
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5299
Practice Address - Country:US
Practice Address - Phone:401-727-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00745207Q00000X
OH58-003649207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology