Provider Demographics
NPI:1568559045
Name:HANDELSMAN, GORDON LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:GORDON
Middle Name:LOUIS
Last Name:HANDELSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 TECHNOLOGY DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-9531
Mailing Address - Country:US
Mailing Address - Phone:412-531-2902
Mailing Address - Fax:412-531-2948
Practice Address - Street 1:3212 MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:MUNHALL
Practice Address - State:PA
Practice Address - Zip Code:15120-3230
Practice Address - Country:US
Practice Address - Phone:412-462-7700
Practice Address - Fax:412-462-7949
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035633E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010859330005Medicaid
B37280Medicare UPIN
122877SB4Medicare ID - Type Unspecified