Doctor Name: | DR. DONALD GORDON |
NPI Number: | 1104810787 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 27018 |
Business Practice Address: | 153 South Main Street Newtown, CT - 06470 |
Business Phone Number: | 2032701077 |
Business Fax Number: | 2032700420 |
Mailing Address: | 16 Hospital Ave, Suite 102 DANBURY |
State: | CT |
Postal Code: | 068105927 |
Phone Number: | 2038304607 |
Fax Number: | |
NPI Enumeration Date: | 09/09/2005 |
NPI Last Update Date: | 11/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 27018 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |