Healthcare Provider Details

I. General information

NPI: 1386030294
Provider Name (Legal Business Name): RHONIA GORDON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2183 3RD AVE APT 303
NEW YORK NY
10035-4464
US

IV. Provider business mailing address

100 N PORTLAND AVE
BROOKLYN NY
11205-2005
US

V. Phone/Fax

Practice location:
  • Phone: 347-853-0481
  • Fax:
Mailing address:
  • Phone: 844-692-4692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number300106
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: