Provider Demographics
NPI:1750304036
Name:GOMEZ, JOSEPH FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:GOMEZ
Suffix:
Gender:M
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:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14240-0488
Mailing Address - Country:US
Mailing Address - Phone:203-944-1940
Mailing Address - Fax:203-916-1041
Practice Address - Street 1:2223 W STATE ST STE 120
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1938
Practice Address - Country:US
Practice Address - Phone:716-710-8266
Practice Address - Fax:716-710-8267
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198335207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01671241Medicaid
NYBA1519OtherGROUP
NYBA1519OtherGROUP
NYRA8812Medicare PIN
NY01671241Medicaid
NYRB2054Medicare PIN
NYRB1518Medicare PIN
NYRB8897Medicare PIN