Provider Demographics
NPI:1013787902
Name:CAIN, GORDON
Entity Type:Individual
Prefix:
First Name:GORDON
Middle Name:
Last Name:CAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W MAIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-4658
Mailing Address - Country:US
Mailing Address - Phone:610-292-8508
Mailing Address - Fax:610-292-8508
Practice Address - Street 1:240 W MAIN ST APT 1
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-4658
Practice Address - Country:US
Practice Address - Phone:610-292-8508
Practice Address - Fax:610-292-8508
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide