Provider Demographics
NPI:1306072772
Name:LAO, EMELITA GOMEZ (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:EMELITA
Middle Name:GOMEZ
Last Name:LAO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MS
Other - First Name:EMELITA
Other - Middle Name:GOMEZ
Other - Last Name:LAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:51 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1239
Mailing Address - Country:US
Mailing Address - Phone:201-451-0269
Mailing Address - Fax:
Practice Address - Street 1:51 SYCAMORE RD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-1239
Practice Address - Country:US
Practice Address - Phone:201-451-0269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO09926400163W00000X, 163WH0200X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health