# LESLIE E. GORDON, MD P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285230722
- **Authorized official:** DR. LESLIE ELLEN GORDON MD (OWNER)
- **Authorized official phone:** (917) 531-0197

## Contact information

- **Practice address:** 2600 NETHERLAND AVE STE 102, BRONX, NY 10463-4813
- **Practice address phone:** (718) 709-0955
- **Mailing address:** 2600 NETHERLAND AVE STE 102, BRONX, NY 10463-4813
- **Mailing address phone:** (718) 709-0955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0120X | Cornea and External Diseases Specialist Physician | — | NULL | Yes |
| 207WX0120X | Cornea and External Diseases Specialist Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/09/2020
- **Last updated:** 07/02/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1104038231 | EMPIRE BCBS | NY |
| 01 | — | 112358021 | 1199 | NY |
| 01 | — | 408107 | GHI | NY |
| 01 | — | 6922512 | CIGNA | NY |
| 01 | — | 9123112 | AETNA | NY |
| 01 | — | P3908626 | OXFORD | NY |