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NPI Code Detail

MEDICARE: LEMAR ANTHONY GORDON LPN

MEDICARE:   LEMAR ANTHONY GORDON  LPN
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
1164W00000XLicensed Practical Nurse337299NY

General Provider Information

NPI Number : 1467099713
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEMAR ANTHONY GORDON LPN
Provider Business Mailing Address
First Line : 41 S BLEEKER ST APT 1
Second Line :
City : MOUNT VERNON
State : NY
Zip : 10550-2629
Country : US
Telephone Number : 929-227-1052
Fax Number : 929-227-1052
Provider Business Practice Location Address
First Line : 41 S BLEEKER ST APT 1
Second Line :
City : MOUNT VERNON
State : NY
Zip : 10550-2629
Country : US
Telephone Number : 929-227-1052
Fax Number : 929-227-1052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2019
Last Update Date : 12/05/2019

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Directions to “ LEMAR ANTHONY GORDON LPN” Practice Location

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