Gordon, Marc L

Gordon, Marc L is an sole proprietor health care provider with primary practice located at 611 Northern Blvd Suite 150, Great Neck NY 11021-5207. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Gordon, Marc L can be contacted via phone (516) 325-7000.

Contact Information

Primary practice address
611 Northern Blvd Suite 150 Great Neck NY 11021-5207
Phone: (516) 325-7000
Fax: (516) 325-7001
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 167360 New York

Profile Details

NPI number 1558459008
LBN Legal business name Gordon, Marc L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 10th, 2006
Last updated Sep 11th, 2015 - about 9 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 1558459008 NPPES
New York MEDICAID 01189591

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