Individual
DR. MARK JAY GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
978 COLVIN BLVD, KENMORE, NY 14217-2128
(716) 871-0074
(716) 898-8973
Mailing address
978 COLVIN BLVD, KENMORE, NY 14217-2128
(716) 871-0074
(716) 898-8973
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NY TUV004506
NY
152W00000X
Optometrist
TUV004506
NY
Other
Enumeration date
05/03/2006
Last updated
10/18/2017
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