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General NPI Number Information
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NPI Number | 1821482837
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Entity Type | Individual
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Provider Name | SARA GORDON
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Gender | Female
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 10701 EAST BLVD
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City | CLEVELAND
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State | OH
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Zip | 44106
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Country | US
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Telephone | 216-791-3800
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Fax | 216-421-3217
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Provider Business Mailing Address
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Address Line | 1217 W 70TH ST
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City | CLEVELAND
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State | OH
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Zip | 44102-2017
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Country | US
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Telephone | 513-292-1555
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | S10751
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19315
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License Number State | AL
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