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Physician Compare National (NPI:1689675449)

HEALTHCARE PROVIDER: GARY M GORDON DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1689675449
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5799786695
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20110727000059
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name GORDON
Individual professional last name
Provider First Name GARY
Individual professional first name
Provider Middle Name M
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Individual professional's medical school
Graduation Year 1973
Individual professional's medical school graduation year
Primary Specialty PODIATRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2285 CROSS RD
Group Practice or individual's line 1 address
City GLENSIDE
Group Practice or individual's city
State PA
Group Practice or individual's state
Zip Code 190385023
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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