Provider Demographics
NPI:1497797641
Name:GORDON, JAMES RUSSELL (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RUSSELL
Last Name:GORDON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:SIGHT MEDICAL DOCTORS, PLLC
Mailing Address - Street 2:450 MAMARONECK AVENUE SUITE 402
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2418
Mailing Address - Country:US
Mailing Address - Phone:855-295-4144
Mailing Address - Fax:631-257-5098
Practice Address - Street 1:450 MAMARONECK AVE
Practice Address - Street 2:STE 402
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2430
Practice Address - Country:US
Practice Address - Phone:914-949-9200
Practice Address - Fax:914-949-4505
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2019-12-16
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Provider Licenses
StateLicense IDTaxonomies
NY208880207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16573Medicare UPIN
NY02208639Medicare ID - Type Unspecified
NY46Z522Medicare ID - Type Unspecified