| Doctor Name: | NED C JORDAN |
| NPI Number: | 1467480293 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPA-C |
| License Number: | 000809 |
| Business Practice Address: | 107 Prospect St Attica, NY - 140111149 |
| Business Phone Number: | 5855916000 |
| Business Fax Number: | 5855916962 |
| Mailing Address: | 9820 S Street Rd, LE ROY |
| State: | NY |
| Postal Code: | 144828815 |
| Phone Number: | 5857682022 |
| Fax Number: | 5855916962 |
| NPI Enumeration Date: | 06/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 000809 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |