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General NPI Number Information
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NPI Number | 1881976868
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Entity Type | Individual
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Provider Name | ANDREA MARIE GORDON PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1719 E 19TH AVE
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City | DENVER
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State | CO
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Zip | 80218-1235
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Country | US
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Telephone | 303-338-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 10350 E DAKOTA AVE
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City | DENVER
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State | CO
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Zip | 80247-1314
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Country | US
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Telephone |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 015077
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA.0005356
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License Number State | CO
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