Individual
MS. MURIEL P GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1080 SUNRISE HWY, MAXINE POSTAL TRI COMMUNITY CLINIC, AMITYVILLE, NY 11701
(631) 854-1022
(631) 854-1031
Mailing address
1080 SUNRISE HWY, MAXINE POSTAL TRI COMMUNITY CLINIC, AMITYVILLE, NY 11701
(631) 854-1022
(631) 854-1031
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F3806541
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01770290
—
NY
Enumeration date
08/09/2006
Last updated
07/08/2007
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