Provider Demographics
NPI:1417248543
Name:VITAL SIGNS MEDICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:VITAL SIGNS MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-781-6869
Mailing Address - Street 1:450 E MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2578
Mailing Address - Country:US
Mailing Address - Phone:845-781-6869
Mailing Address - Fax:845-675-5061
Practice Address - Street 1:450 E MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2578
Practice Address - Country:US
Practice Address - Phone:845-781-6869
Practice Address - Fax:845-675-5061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-23
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192255207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty