Provider Demographics
NPI:1417218413
Name:GORDON, ALLISON RACHEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:RACHEL
Last Name:GORDON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MADISON AVE STE 2500
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1101
Mailing Address - Country:US
Mailing Address - Phone:212-532-1400
Mailing Address - Fax:
Practice Address - Street 1:275 MADISON AVE STE 2500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1101
Practice Address - Country:US
Practice Address - Phone:212-532-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02494100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist