Healthcare Provider Details

I. General information

NPI: 1396659561
Provider Name (Legal Business Name): GORDON MEDICAL PLUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 W STATE ST FL 2
MEDIA PA
19063-3105
US

IV. Provider business mailing address

206 W STATE ST FL 2
MEDIA PA
19063-3105
US

V. Phone/Fax

Practice location:
  • Phone: 610-602-9703
  • Fax: 610-602-9739
Mailing address:
  • Phone: 610-602-9703
  • Fax: 610-602-9739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. DANIEL DELANO GORDON SR.
Title or Position: CEO
Credential:
Phone: 610-602-9703