MEDICARE: GORDON CONRAD ANTHONY ERB PA-C

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
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1942148325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GORDON CONRAD ANTHONY ERB PA-C

Provider Business Mailing Address
First Line	:	925 CHESTNUT ST STE 110
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4201
Country	:	US
Telephone Number	:	215-955-6996
Fax Number	:	215-955-1122

Provider Business Practice Location Address
First Line	:	925 CHESTNUT ST STE 110
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4201
Country	:	US
Telephone Number	:	215-955-6996
Fax Number	:	215-955-1122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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