| Gordon Wellness Center Llc | |
|
270 Pierce St Ste 302 Kingston PA 18704-5141 | |
| (272) 322-0037 | |
| Not Available |
| Full Name | Gordon Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 270 Pierce St Ste 302, Kingston, Pennsylvania |
| Authorized Official Name and Position | Steven Gordon (OWNER) |
| Authorized Official Contact | 2159171007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon Wellness Center Llc 270 Pierce St Ste 302 Kingston PA 18704-5141 Ph: (272) 322-0037 | Gordon Wellness Center Llc 270 Pierce St Ste 302 Kingston PA 18704-5141 Ph: (272) 322-0037 |
| NPI Number | 1649986746 |
|---|---|
| Provider Enumeration Date | 01/24/2023 |
| Last Update Date | 01/24/2023 |
| Certification Date | 01/24/2023 |
| Medicare PECOS PAC ID | 0042668220 |
|---|---|
| Medicare Enrollment ID | O20231129000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649986746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Steven M Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427477041 PECOS PAC ID: 0648494369 Enrollment ID: I20161027001201 |
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