Individual
ELOISE MIEKLE GORDON-MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
1000 10TH AVE, NEW YORK, NY 10019-1147
(212) 636-3443
(212) 523-8189
Mailing address
222 EVERETT PL, ENGLEWOOD, NJ 07631-1660
(201) 871-4226
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
440265
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440265
NEW YORK STATE REGISTERED PROFESSIONAL NURSE
NY
01
—
F337206
NEW YORK STATE NURSE PRACTITIONER LICENSE
NY
Enumeration date
05/14/2013
Last updated
09/11/2025
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