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General NPI Number Information
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NPI Number | 1780079236
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Entity Type | Individual
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Provider Name | AYLA GORDON M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 400 MATTHEW ST STE 305
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City | MARIETTA
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State | OH
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Zip | 45750-1600
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Country | US
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Telephone | 740-568-5662
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Fax |
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Provider Business Mailing Address
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Address Line | 99 BEAUVOIR AVE
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City | SUMMIT
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State | NJ
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Zip | 07901-3533
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Country | US
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Telephone | 909-522-2000
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 35.142330
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 35.142330
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License Number State | OH
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