Individual
MICHAEL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23 KNOTT DR, GLEN COVE, NY 11542-4116
(516) 759-1528
(516) 759-1528
Mailing address
23 KNOTT DR, GLEN COVE, NY 11542-4116
(516) 759-1528
(516) 759-1528
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
135718
NY
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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