DR. MICHELLE ELAINE GORDON D.O. NPI 1295770907

NPI Information

NPI: 1295770907
Provider Name: DR. MICHELLE ELAINE GORDON, D.O.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
11 PEEKSKILL HOLLOW RD # 97
PUTNAM VALLEY, NY
ZIP 10579
Phone: (845) 526-2080
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DR. Michelle Elaine Gordon, D.O. is a specialist in Putnam Valley, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Michelle Elaine Gordon, D.O. NPI is 1295770907. 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:

11 PEEKSKILL HOLLOW RD # 97
PUTNAM VALLEY, NY
ZIP 10579-200
Phone: (845) 526-2080
Fax: (845) 526-2082

The NPI 1295770907 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/17/2006 and was last updated on 12/19/2012.

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	174400000X	Specialist		236050-1	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	I42707	MEDICARE UPIN	NEW YORK
2	2682460	MEDICAID	NEW YORK
3	4879H1	OTHER	NEW YORK	MEDICARE PETAN

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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