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NPI Code Detail

MEDICARE: ALISON GORDIN

MEDICARE:   ALISON  GORDIN
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
1225100000XPhysical TherapistPTH12433AL

General Provider Information

NPI Number : 1558246504
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISON GORDIN
Provider Business Mailing Address
First Line : 26 OLD TOWN LN
Second Line :
City : HALESITE
State : NY
Zip : 11743-2215
Country : US
Telephone Number : 631-678-7713
Fax Number :
Provider Business Practice Location Address
First Line : 200 MONTGOMERY HWY STE 150
Second Line :
City : VESTAVIA HILLS
State : AL
Zip : 35216-1898
Country : US
Telephone Number : 205-822-0067
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2025
Last Update Date : 08/08/2025

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