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Kimberly L Gordon
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NPI Number Detailed Information
Provider Information:
| Name: | Kimberly L Gordon |
| Gender: | F |
| Provider License Number If Given: | MD023999E |
NPI Information:
| NPI: | 1619970894 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 5/23/2005 |
| Last Update Date: | 12/5/2018 |
Provider Business Mailing Address:
| Address: | 11279 PERRY HWY STE 450 Wexford, PA 15090 |
| Phone Number: | 7249331100 |
| Fax Number: | 7249331160 |
Provider Business Practice Location Address:
| Address: | 604 EPSILON DR Pittsburgh, PA 15238 |
| Phone Number: | 4129679090 |
| Fax Number: | 4129670186 |
Provider Taxonomy:
| Primary: | 208000000X |
| Secondary (if any): | |
| State: | PA |
