Provider Demographics
NPI:1881804664
Name:GORDON DUBS, KELLY C (MD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:C
Last Name:GORDON DUBS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:250 PETTIT AVENUE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710
Mailing Address - Country:US
Mailing Address - Phone:516-409-0106
Mailing Address - Fax:516-409-0108
Practice Address - Street 1:250 PETTIT AVENUE
Practice Address - Street 2:SUITE 4
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:516-409-0106
Practice Address - Fax:516-409-0108
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2010-03-11
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Provider Licenses
StateLicense IDTaxonomies
NY232457207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology