MEDICARE: KATALIN GORDON LAC

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	171100000X	Acupuncturist	001059	NY
2	171100000X	Acupuncturist	25MZ00011500	NJ

General Provider Information

NPI Number	:	1336284652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATALIN GORDON LAC

Provider Business Mailing Address
First Line	:	211 PARK PL
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-4103
Country	:	US
Telephone Number	:	862-224-6796
Fax Number	:	973-771-3834

Provider Business Practice Location Address
First Line	:	605 VALLEY RD
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07043-1459
Country	:	US
Telephone Number	:	862-224-6796
Fax Number	:	973-771-3834

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	03/03/2026

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Directions to “ KATALIN GORDON LAC” Practice Location

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