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General NPI Number Information
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NPI Number | 1275795718
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Entity Type | Individual
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Provider Name | BIRDIE MAY NASH GORDON RN
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Gender | Female
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 13 CLEVELAND ST JOS-EL CARE AGENCY
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City | VALLEY STREAM
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State | NY
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Zip | 11580
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Country | US
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Telephone | 516-902-6851
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Fax |
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Provider Business Mailing Address
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Address Line | 1854 FREEMAN AVE
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City | ELMONT
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State | NY
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Zip | 11003
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Country | US
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Telephone | 516-902-6851
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 297850
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License Number State | NY
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