Provider Demographics
NPI:1760970966
Name:GORDON, MOLLY KAPLAN (MD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:KAPLAN
Last Name:GORDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3446
Mailing Address - Country:US
Mailing Address - Phone:484-476-4650
Mailing Address - Fax:484-476-2422
Practice Address - Street 1:100 E LANCASTER AVE STE 301
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3446
Practice Address - Country:US
Practice Address - Phone:484-476-4650
Practice Address - Fax:484-476-2422
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
PAMD477320207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program