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Organization

LESLIE E. GORDON, MD P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LESLIE ELLEN GORDON MD (OWNER)
(917) 531-0197
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207WX0120X
Cornea and External Diseases Specialist Physician
Primary

Other

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
Enumeration date
12/09/2020
Last updated
07/02/2021
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