Individual
DR. KRISTIN SHALLCROSS GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
600 COMMUNITY DR STE 302, MANHASSET, NY 11030-3818
(516) 823-8808
Mailing address
PO BOX 3055, SAG HARBOR, NY 11963-0403
(631) 377-1036
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2782841
NY
Other
Enumeration date
08/12/2010
Last updated
12/19/2018
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