Provider Demographics
NPI:1760696769
Name:GOMEZ, CLAUDIO (DPM)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIO
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 7TH ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-1643
Mailing Address - Country:US
Mailing Address - Phone:908-755-5500
Mailing Address - Fax:
Practice Address - Street 1:120 W 7TH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060
Practice Address - Country:US
Practice Address - Phone:908-755-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00298900213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0325091Medicaid