Gordon, Larry

Gordon, Larry is an individual health care provider with primary practice located at 87 Washington St , Conway NH 03818-6044. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gordon, Larry can be contacted via phone (603) 447-3347.

Contact Information

Primary practice address
87 Washington St Conway NH 03818-6044
Phone: (603) 447-3347
Fax: (603) 447-1022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1033446083
LBN Legal business name Gordon, Larry
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 12th, 2009
Last updated Nov 12th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033446083 NPPES
New Hampshire MEDICAID 81263824

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