Provider Demographics
NPI:1902528342
Name:GOMES FERNANDES, ANA MARCELA (L AC, DIPL OM)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARCELA
Last Name:GOMES FERNANDES
Suffix:
Gender:F
Credentials:L AC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SUNNY OAKS TER
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03884-6839
Mailing Address - Country:US
Mailing Address - Phone:914-621-6394
Mailing Address - Fax:
Practice Address - Street 1:123 SUNNY OAKS TER
Practice Address - Street 2:
Practice Address - City:STRAFFORD
Practice Address - State:NH
Practice Address - Zip Code:03884-6839
Practice Address - Country:US
Practice Address - Phone:914-621-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH324171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist