Mrs Miriam Renee Gordon, PT | |
300 Hempstead Tpke, West Hempstead, NY 11552-1450 | |
(516) 505-2200 | |
Not Available |
Full Name | Mrs Miriam Renee Gordon |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 300 Hempstead Tpke, West Hempstead, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245459494 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 010479 (New York) | Primary |
Provider Name | Montefiore Medical Center |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1063525152 PECOS PAC ID: 3779496021 Enrollment ID: O20031113000235 |
Mailing Address | Practice Location Address |
---|---|
Mrs Miriam Renee Gordon, PT 800 Evergreen Dr, West Hempstead, NY 11552-3408 Ph: (516) 486-2509 | Mrs Miriam Renee Gordon, PT 300 Hempstead Tpke, West Hempstead, NY 11552-1450 Ph: (516) 505-2200 |
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