Shaw, Eric Gorgon

Shaw, Eric Gorgon is an individual health care provider with primary practice located at 4900 Broad Rd , Syracuse NY 13215-2265. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Shaw, Eric Gorgon can be contacted via phone (315) 492-5535.

Contact Information

Primary practice address
4900 Broad Rd Syracuse NY 13215-2265
Phone: (315) 492-5535
Fax: (315) 492-8690
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 224829 New York

Profile Details

NPI number 1821058207
LBN Legal business name Shaw, Eric Gorgon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Aug 14th, 2013 - about 11 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 1821058207 NPPES
New York Other P00869153 RAILROAD MEDICARE
New York MEDICAID 02650246 RAILROAD MEDICARE

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