Individual
DR. JOEL PETER GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3455 MAIN ST, SUITE 5, SPRINGFIELD, MA 01107-1142
(413) 733-9600
Mailing address
453 AUDUBON RD, LEEDS, MA 01053-9771
(413) 585-9157
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
78013
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043238282
AETNA
MA
01
—
12706
HEALTH NEW ENGLAND
MA
01
—
3147062
CIGNA
MA
01
—
4500254
AETNA
MA
01
—
747282
CONNECTICARE
MA
01
—
758399
TUFTS HEALTH PLANS
MA
01
—
J14217
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/24/2006
Last updated
02/10/2017
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