MEDICARE: DR. GORDON M KAPLAN M.D.

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	2086S0122X	Plastic and Reconstructive Surgery Physician	25MA07926000	NJ
2	2086S0122X	Plastic and Reconstructive Surgery Physician	2403491	NY

General Provider Information

NPI Number	:	1871799080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GORDON M KAPLAN M.D.

Provider Business Mailing Address
First Line	:	1033 RIVER RD STE 1
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1351
Country	:	US
Telephone Number	:	201-710-7771
Fax Number	:	201-300-0119

Provider Business Practice Location Address
First Line	:	1033 RIVER RD
Second Line	:	UNIT 1
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1351
Country	:	US
Telephone Number	:	201-710-7771
Fax Number	:	201-300-0119

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	06/18/2024

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