Organization
MIRIAM GORDON PEDIATRIC NP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM BLAU NP (CEO)
(718) 815-8122
Entity
Organization
Contact information
Practice address
7 ISMAY STREET, STATEN ISLAND, NY 10314
(718) 815-1000
(718) 815-1000
Mailing address
7 ISMAY STREET, STATEN ISLAND, NY 10314
(718) 815-1000
(718) 815-8122
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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