Individual provider · NPI-1
Jerry Jason Gomez, CHSD
Day Training/Habilitation Specialist · Brooklyn, NY
NPI number1114769692
StatusActive
Last updated in NPPESJun 6, 2024
Details
- NPI
- 1114769692
- Entity type
- Individual (NPI-1)
- Name
- Jerry Jason Gomez
- Credential
- CHSD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 6, 2024
- Certification date
- Jun 6, 2024
- Last updated
- Jun 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | – | Yes |
Practice location
1623 Flatbush AveBrooklyn, NY 11210-3262
Phone 718-377-5755
Mailing address
335 48th StBrooklyn, NY 11220-1113
Phone 347-495-4160
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