MEDICARE: JASMIN GORDON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235889932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMIN GORDON

Provider Business Mailing Address
First Line	:	1715 BELLE HAVEN DR APT 302
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-4017
Country	:	US
Telephone Number	:	202-492-4819
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 PIERCE ST NE UNIT 1332
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3063
Country	:	US
Telephone Number	:	202-847-9007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2022
Last Update Date	:	03/25/2022

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Directions to “ JASMIN GORDON ” Practice Location

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