Individual
MARC L GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 NORTHERN BLVD, SUITE 150, GREAT NECK, NY 11021-5207
(516) 325-7000
(516) 325-7001
Mailing address
175 COMMUNITY DR, GREAT NECK, NY 11021-5502
(516) 465-1900
(516) 465-1830
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
167360
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01189591
—
NY
Enumeration date
10/10/2006
Last updated
09/11/2015
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