| Doctor Name: | DR. JORDAN S GITLIN |
| NPI Number: | 1164450300 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 203315 |
| Business Practice Address: | 247 Route 100 Suite 1002 Somers, NY - 105893231 |
| Business Phone Number: | 9149628290 |
| Business Fax Number: | 9149628851 |
| Mailing Address: | 1999 Marcus Ave, Suite M18 NEW HYDE PARK |
| State: | NY |
| Postal Code: | 110421017 |
| Phone Number: | 5164666953 |
| Fax Number: | 5164665608 |
| NPI Enumeration Date: | 06/28/2006 |
| NPI Last Update Date: | 01/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2088P0231X |
| License Number: | 203315 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Urology |
| Taxonomy Specialization: | Pediatric Urology |
| Taxonomy Definition: | Surgeons who can diagnose, treat, and manage children |