Individual
LAWRENCE JAY GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2004 ROUTE 17M, GOSHEN, NY 10924-5210
(845) 294-0661
(845) 818-9646
Mailing address
2004 ROUTE 17M, GOSHEN, NY 10924-5210
(845) 294-0661
(845) 818-9646
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
183723
NY
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
183723
NY
207YX0602X
Otolaryngic Allergy Physician
183723
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01515700
—
NY
01
—
0182804
GHI
—
01
—
040007473
RAILROAD MEDICARE
NY
01
—
047123
MVP
NY
01
—
10000172090012
AFFINITY HEALTH PLAN
—
01
—
10035906
CDPHP
NY
01
—
116999
WELLCARE
NY
01
—
120076
GHI HMO
NY
01
—
3824829
OXFORD
—
01
—
384148P
HIP
NY
01
—
4572033
AETNA
NY
01
—
8M7342
BCBS NY
—
01
—
ZE3167
HEALTHNET OF NORTHEAST
—
Enumeration date
11/25/2005
Last updated
10/09/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us