Provider Demographics
NPI:1548356058
Name:GORDON, SETH DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:DAVID
Last Name:GORDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E 9TH ST
Mailing Address - Street 2:6L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5944
Mailing Address - Country:US
Mailing Address - Phone:917-288-6648
Mailing Address - Fax:435-921-1950
Practice Address - Street 1:20 E 9TH ST
Practice Address - Street 2:6L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5944
Practice Address - Country:US
Practice Address - Phone:917-288-6648
Practice Address - Fax:435-921-1950
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY231449208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics