Organization
BERNARD J. GORDON MD PA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI MOULTON (BILLING)
(207) 504-1079
Entity
Organization
Contact information
Practice address
145 NEWBURY ST FL 1, PORTLAND, ME 04101-4261
(207) 772-5400
(207) 772-5402
Mailing address
145 NEWBURY ST FL 1, PORTLAND, ME 04101-4261
(207) 772-5400
(207) 772-5402
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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