Provider Demographics
NPI:1750348900
Name:GOMES, ANA P (DO, CMD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:P
Last Name:GOMES
Suffix:
Gender:F
Credentials:DO, CMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BRASS CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-6309
Mailing Address - Country:US
Mailing Address - Phone:908-835-1910
Mailing Address - Fax:908-835-1924
Practice Address - Street 1:410 COVENTRY CENTRE DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865
Practice Address - Country:US
Practice Address - Phone:908-454-9902
Practice Address - Fax:908-454-9905
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB064321207Q00000X
PAOS009085L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2105913OtherAETNA
NJ223733353OtherHORIZON
NJ7387601Medicaid
NJ223733353OtherHORIZON
G60187Medicare UPIN