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General NPI Number Information
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NPI Number | 1346144144
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Entity Type | Organization
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Legal Business Name | GORDON & MALTZ P.C.
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 305 TITUSVILLE RD
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-2917
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Country | US
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Telephone | 845-226-5156
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Fax |
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Provider Business Mailing Address
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Address Line | 305 TITUSVILLE RD
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-2917
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Country | US
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Telephone | 845-226-5156
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Fax |
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Authorized Official
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Title or Position | VP, PAYOR RELATIONS
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Name | MICHAELA MUNIZ
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Credential |
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Telephone | 469-324-3242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State | NULL
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