Provider Demographics
NPI:1942715560
Name:GORDON SCHECTMAN MEDICAL, LLC
Entity Type:Organization
Organization Name:GORDON SCHECTMAN MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHECTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-444-3934
Mailing Address - Street 1:1340 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5703
Mailing Address - Country:US
Mailing Address - Phone:718-444-3934
Mailing Address - Fax:
Practice Address - Street 1:2952 BRIGHTON 3RD ST STE 401
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6897
Practice Address - Country:US
Practice Address - Phone:718-975-3833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty