1205091782 NPI number — MS. ERIKA L GORDON MSW

Table of content: MS. ERIKA L GORDON MSW (NPI 1205091782)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205091782 NPI number — MS. ERIKA L GORDON MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GORDON
Provider First Name:
ERIKA
Provider Middle Name:
L
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRENCH
Provider Other First Name:
ERIKA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1205091782
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16220 FREDERICK RD
Provider Second Line Business Mailing Address:
SUITE 502
Provider Business Mailing Address City Name:
GAITHERSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20877-4039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-978-9750
Provider Business Mailing Address Fax Number:
301-978-9753

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16220 FREDERICK RD
Provider Second Line Business Practice Location Address:
SUITE 502
Provider Business Practice Location Address City Name:
GAITHERSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20877-4039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-978-9750
Provider Business Practice Location Address Fax Number:
301-978-9753
Provider Enumeration Date:
07/23/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  14094 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)