Healthcare Provider Details

I. General information

NPI: 1548287568
Provider Name (Legal Business Name): RICHARD D GORDON, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 KLOCKNER RD
HAMILTON NJ
08690-3417
US

IV. Provider business mailing address

2121 KLOCKNER RD
HAMILTON NJ
08690-3417
US

V. Phone/Fax

Practice location:
  • Phone: 609-587-9898
  • Fax: 609-584-1774
Mailing address:
  • Phone: 609-587-9898
  • Fax: 609-584-1774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JUDITH S GORDON
Title or Position: BUSINESS MANAGER
Credential:
Phone: 609-587-9898