Provider Demographics
NPI:1467427799
Name:GORDON, STANLEY L (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:L
Last Name:GORDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:44 ROCKLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:PELHAM MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10803-3311
Mailing Address - Country:US
Mailing Address - Phone:914-738-3854
Mailing Address - Fax:914-738-0133
Practice Address - Street 1:450 CLARKSON AVENUE
Practice Address - Street 2:BOX 30
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2098
Practice Address - Country:US
Practice Address - Phone:718-270-6317
Practice Address - Fax:718-270-3983
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY146180-1207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery