Healthcare Provider Details

I. General information

NPI: 1548172869
Provider Name (Legal Business Name): JULIA GORDON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CHATSWORTH AVE
LARCHMONT NY
10538-2903
US

IV. Provider business mailing address

68 N HENRY ST PH 5A
BROOKLYN NY
11222-8213
US

V. Phone/Fax

Practice location:
  • Phone: 914-833-4103
  • Fax:
Mailing address:
  • Phone: 929-799-2489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074143
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: