1477649424 NPI number — DR. RICHARD N. GORDON M.D.

Table of content: AYMAN AL-REJLEH MD (NPI 1184698300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477649424 NPI number — DR. RICHARD N. GORDON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GORDON
Provider First Name:
RICHARD
Provider Middle Name:
N.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477649424
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 MEDICAL PARK DRIVE
Provider Second Line Business Mailing Address:
RAMAPO OPHTHALMOLOGY ASSOCIATES, LLP
Provider Business Mailing Address City Name:
POMONA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10970-3534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-362-1450
Provider Business Mailing Address Fax Number:
845-362-3830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 MEDICAL PARK DRIVE
Provider Second Line Business Practice Location Address:
RAMAPO OPHTHALMOLOGY ASSOCIATES, LLP
Provider Business Practice Location Address City Name:
POMONA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10970-3534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-362-1450
Provider Business Practice Location Address Fax Number:
845-362-3830
Provider Enumeration Date:
10/05/2006

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: 174400000X , with the licence number:  198639 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000037227 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 061536408 . This is a "HUDSON HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 451611 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 696738 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1228868 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 061536408 . This is a "1199 NATIONAL BENEFIT FUN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 061536408 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 198639 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 061536408 . This is a "FIDELIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000004312 . This is a "AFFINITY HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5789423 . This is a "AETNA HMO & PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 061536408 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: OD1543 . This is a "HEALTH NET OF NE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02202748 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 180043792 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6013930 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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