Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | 35.125857 | OH |
Y | 2080A0000X | Adolescent Medicine | 79775 | MA |
N | 2080A0000X | Adolescent Medicine | MD14044 | RI |
N | 2080P0205X | Pediatric Endocrinologist | 35.125857 | OH |
N | 2080P0205X | Pediatric Endocrinologist | MD14044 | RI |
NPI | 1326110545 |
---|---|
Provider Name | Dr. Catherine M Gordon |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 03/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD14044 | LICENSE (01) | RI |