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Contact Information

RICARDO A GOMEZ VASQUEZ, MD
550 MOUNT PROSPECT AVE
NEWARK, NJ07104-1530
 Phone: 973-482-4697
 Fax: 973-482-0893
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for RICARDO A GOMEZ VASQUEZ · (Male)

NPI # 1801053715
Status Active
Credentials MD
Entity Individual
Enumeration date 05/19/2008
Last updated 05/04/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 48241
  • NJ License # 25MA09202200
  • NY License # 267260
  • TX License # N7265
  • NJ Medicaid 0331651
  • CT Other 48241 CONNECTICUT MEDICAL LICENCE
  • NJ Other 25MA09202200 NJ MEDICAL LICENSE
  • NY Other 267260 NEW YORK MEDICAL LICENSE
  • TX Other N7265 TEXAS MEDICAL LICENSE
Hospital affiliation(s)
  • SAINT MICHAEL'S MEDICAL CENTER INC - (Acute Care)
    111 CENTRAL AVENUE
    NEWARK, NJ 07102
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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