Doctor Name: | IVYLYN GORDON |
NPI Number: | 1003935941 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 030714 |
Business Practice Address: | 3480 Seymour Ave Apt # 1 B Bronx, NY - 104692144 |
Business Phone Number: | 7188823100 |
Business Fax Number: | |
Mailing Address: | Po Box 690012, BRONX |
State: | NY |
Postal Code: | 104690760 |
Phone Number: | 7188823100 |
Fax Number: | |
NPI Enumeration Date: | 03/29/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 030714 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |