IVYLYN GORDON NPI 1003935941

NPI Information

NPI: 1003935941
Provider Name: IVYLYN GORDON
Classification: Licensed Practical Nurse - 164W00000X
Entity Type: Individual
Address:
3480 SEYMOUR AVE
APT # 1 B
BRONX, NY
ZIP 10469
Phone: (718) 882-3100
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Ivylyn Gordon is a licensed practical nurse in Bronx, NY. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Ivylyn Gordon NPI is 1003935941. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3480 SEYMOUR AVE
APT # 1 B
BRONX, NY
ZIP 10469-144
Phone: (718) 882-3100

The enumeration date for this NPI number is 3/29/2007 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	164W00000X	Licensed Practical Nurse		030714	CONNECTICUT	No
2	164W00000X	Licensed Practical Nurse		183896-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01686497	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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