Organization
NIOS SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA GORDON M.D (CEO)
(212) 863-9058
Entity
Organization
Contact information
Practice address
315 W 57TH ST, SUITE 308, NEW YORK, NY 10019-3158
(212) 863-9058
Mailing address
315 W 57TH ST, SUITE 308, NEW YORK, NY 10019-3158
(212) 863-9058
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
04/23/2017
Last updated
04/23/2017
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