Provider Demographics
NPI:1710381959
Name:GORDON, HAROLD (MSW)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:
Last Name:GORDON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 DREXEL AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-3306
Mailing Address - Country:US
Mailing Address - Phone:610-766-1443
Mailing Address - Fax:
Practice Address - Street 1:1001 DREXEL AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-3306
Practice Address - Country:US
Practice Address - Phone:610-766-1443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker