Organization
DAVID GORDON DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GORDON DPM (OWNER)
(718) 327-3968
Entity
Organization
Contact information
Practice address
224 BEACH 20TH ST, FAR ROCKAWAY, NY 11691-3618
(718) 327-3968
Mailing address
224 BEACH 20TH ST, FAR ROCKAWAY, NY 11691-3618
(718) 327-3968
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N006085
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02778045
—
NY
Enumeration date
04/18/2012
Last updated
01/28/2021
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