Individual
DR. LESLIE ELLEN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3777 BROADWAY, NEW YORK, NY 10032-1541
(212) 926-0336
(212) 926-0212
Mailing address
3777 BROADWAY, NEW YORK, NY 10032-1541
(212) 926-0336
(212) 926-0212
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
243820
NY
207W00000X
Ophthalmology Physician
25MA08313100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02917788
—
NY
Enumeration date
05/03/2007
Last updated
03/07/2008
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