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General NPI Number Information
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NPI Number | 1144963380
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Entity Type | Individual
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Provider Name | MS. MADALYN ALLYN GORDON
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Gender | Female
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 2994 N 2ND ST
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City | HARRISBURG
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State | PA
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Zip | 17110-1201
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Country | US
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Telephone | 717-233-1681
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Fax |
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Provider Business Mailing Address
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Address Line | 3224 DUNLAP LN APT O
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City | MECHANICSBURG
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State | PA
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Zip | 17055-7057
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW140717
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License Number State | PA
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