Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 232974 | NY |
NPI | 1083718407 |
---|---|
Provider Name | David S Gordon |
First Address | New York, NY 10019-4417 |
Second Address | Bronx, NY 10467 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 08/07/2007 |