Van-Gorder, Thomas R

Van-Gorder, Thomas R is an individual health care provider with primary practice located at 240 Riverside Dr , Johnson City NY 13790-2732. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Van-Gorder, Thomas R can be contacted via phone (607) 798-9356.

Contact Information

Primary practice address
240 Riverside Dr Johnson City NY 13790-2732
Phone: (607) 798-9356
Fax: (607) 797-1707
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 155343-1 New York

Profile Details

NPI number 1568486843
LBN Legal business name Van-Gorder, Thomas R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Apr 16th, 2021 - about 3 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 1568486843 NPPES
New York MEDICAID 01014626

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