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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

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