Provider Demographics
NPI:1093810053
Name:GOR, NATALIE (DDS)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:GOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 YORK AVE STE S-A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6828
Mailing Address - Country:US
Mailing Address - Phone:212-828-4200
Mailing Address - Fax:877-824-6708
Practice Address - Street 1:1751 YORK AVE STE S-A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6828
Practice Address - Country:US
Practice Address - Phone:212-828-4200
Practice Address - Fax:877-824-6708
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05036011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice