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NPI Code Detail

MEDICARE: BEVERLY M GORDON PT

MEDICARE: BEVERLY M GORDON PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT001013EPA

General Provider Information

NPI Number : 1225154495
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY M GORDON PT
Provider Business Mailing Address
First Line : 3043 EDMONDS RD
Second Line :
City : LAFAYETTE HILL
State : PA
Zip : 19444-2029
Country : US
Telephone Number : 610-941-7599
Fax Number :
Provider Business Practice Location Address
First Line : 1700 PINE ST
Second Line :
City : NORRISTOWN
State : PA
Zip : 19401-3040
Country : US
Telephone Number : 610-239-7100
Fax Number : 610-372-3248
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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Directions to “ BEVERLY M GORDON PT” Practice Location

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