Individual
ZACHARY VAN GORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10 CARLTON DR, PARISH, NY 13131-3308
(315) 625-4388
Mailing address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6569
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
027726
NY
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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