Individual
JACK M GORMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1425 MADISON AVE, BOX 1230, NEW YORK, NY 10029
(212) 659-8763
(212) 860-3945
Mailing address
2700 ARLINGTON AVE, BRONX, NY 10463
(718) 601-2927
(212) 860-3945
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
134700
NY
Other
Enumeration date
08/23/2005
Last updated
07/08/2007
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