MEDICARE: AVA 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	164W00000X	Licensed Practical Nurse	PN268026	PA

General Provider Information

NPI Number	:	1518748722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVA GORDON

Provider Business Mailing Address
First Line	:	704 KENILWORTH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19126-3715
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 KENILWORTH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19126-3715
Country	:	US
Telephone Number	:	347-249-2499
Fax Number	:

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

Provider Enumeration Date	:	10/12/2023
Last Update Date	:	10/12/2023

Similar Medicare Providers

1790326346 — LIVE SPRING HEATHCARE SERVICES
Practice Location Address:

704 KENILWORTH AVE
PHILADELPHIA, PA
19126-3715

Practice Phone: 347-249-2499
Practice Fax:

1881458859 — RICHARD OGBONNA AKACHUKWU
Practice Location Address:

704 KENILWORTH AVE
PHILADELPHIA, PA
19126-3715

Practice Phone: 347-249-2499
Practice Fax:

1356213219 — OAKLANE HEALTH AND WELLNESS, LLC
Practice Location Address:

704 KENILWORTH AVE
PHILADELPHIA, PA
19126-3715

Practice Phone: 347-249-2499
Practice Fax:

1073967295 — MO CHEN MD
Practice Location Address:

2200 BENJAMIN FRANKLIN PKWY APT N508
PHILADELPHIA, PA
19130-3715

Practice Phone: 214-604-9687
Practice Fax:

1356886519 — MISS MICHELLE HAYES PA-C
Practice Location Address:

4529 MARPLE ST
PHILADELPHIA, PA
19136-3715

Practice Phone: 215-834-5865
Practice Fax:

1861007304 — EMMANUEL'S PROFESSIONAL SERVICES LLC
Practice Location Address:

6009 TORRESDALE AVE
PHILADELPHIA, PA
19135-3715

Practice Phone: 267-388-6941
Practice Fax:

Directions to “ AVA GORDON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.