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NPI Code Detail

MEDICARE: SHAMOYA GORDON PA

MEDICARE: SHAMOYA GORDON PA
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1821944786
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAMOYA GORDON PA
Provider Business Mailing Address
First Line : 160 CONVENT AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10031-9198
Country : US
Telephone Number : 212-650-7746
Fax Number :
Provider Business Practice Location Address
First Line : 160 CONVENT AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10031-9198
Country : US
Telephone Number : 212-650-7746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ SHAMOYA GORDON PA” Practice Location

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