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1427097500 NPI number — LEONARD F GORDON MD

NPI Number: 1427097500
Health Care Provider/Practitioner: LEONARD F GORDON MD

Information about “1427097500” NPI (LEONARD F GORDON MD) exists in 1427097500 in HTML format HTML  |  1427097500 in plain Text format TXT  |  1427097500 in PDF (Portable Document Format) PDF  |  1427097500 in an XML format XML  formats.

NPI Number : 1427097500 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1427097500",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GORDON",
    "FirstName": "LEONARD",
    "MiddleName": "F",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "134 BRIDGETON PIKE STE D",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MULLICA HILL",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "08062-2616",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "856-339-6054",
    "MailingAddressFaxNumber": "856-935-6714",
    "FirstLinePracticeLocationAddress": "310 SALEM WOODSTOWN RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SALEM",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08079-2064",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "856-339-6054",
    "PracticeLocationAddressFaxNumber": "856-935-6714",
    "EnumerationDate": "06/05/2006",
    "LastUpdateDate": "01/30/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2085B0100X",
          "TaxonomyName": "Body Imaging Physician",
          "LicenseNumber": "MD021520E",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2085R0202X",
          "TaxonomyName": "Diagnostic Radiology Physician",
          "LicenseNumber": "25MA05000400",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2085R0202X",
          "TaxonomyName": "Diagnostic Radiology Physician",
          "LicenseNumber": "MD021520E",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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