Individual
NED C JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
107 PROSPECT ST, ATTICA, NY 14011-1149
(585) 591-6000
(585) 591-6962
Mailing address
9820 S STREET RD, LE ROY, NY 14482-8815
(585) 768-2022
(585) 591-6962
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000809
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000809
LICENSE
NY
Enumeration date
06/29/2006
Last updated
07/08/2007
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