Gordon, Michelle Elaine

Gordon, Michelle Elaine is an sole proprietor health care provider with primary practice located at 11 Peekskill Hollow Rd # 97 , Putnam Valley NY 10579-3200. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Gordon, Michelle Elaine can be contacted via phone (845) 526-2080.

Contact Information

Primary practice address
11 Peekskill Hollow Rd # 97 Putnam Valley NY 10579-3200
Phone: (845) 526-2080
Fax: (845) 526-2082
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 236050-1 New York

Profile Details

NPI number 1295770907
LBN Legal business name Gordon, Michelle Elaine
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 17th, 2006
Last updated Dec 19th, 2012 - about 12 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 1295770907 NPPES
New York Other 4879H1 MEDICARE PETAN
New York MEDICAID 2682460 MEDICARE PETAN

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