Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 280176 | NY |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 280176- | NY |
NPI | 1467611608 |
---|---|
Provider Name | Dr. Jaime Andres Gomez Hernandez |
First Address | Bronx, NY 10467-2404 |
Second Address | Bronx, NY 10467-2404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 31/08/2015 |