National Provider Identifier
Brian Phillip Glen Gordon SR.
Brian Phillip Glen Gordon SR. is listed in the NPPES registry with a primary specialty of Driver in Buffalo, NY and a listed phone number of (716) 931-9899.
Profile Overview
- NPI
- 1740509165
- Provider Type
- Individual
- Primary Specialty
- Driver
- Enumeration Date
- May 25, 2010
- Last Updated
- May 25, 2010
Practice Location
- 29 Cambridge Ave
- 29 Cambridge Ave.
- Buffalo, NY 14215-4001
Phone: (716) 931-9899
Specialties
- Driver (172A00000X)
Full Record
- NPI
- 1740509165
- Entity Type
- Individual
- Last Name
- Gordon
- First Name
- Brian
- Middle Name
- Phillip Glen
- Name Prefix
- Mr.
- Name Suffix
- SR.
- Mailing Street Address
- 29 Cambridge Ave
- Mailing Address Line 2
- 29 Cambridge Ave.
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14215-4001
- Mailing Country
- US
- Mailing Phone
- (716) 931-9899
- Practice Street Address
- 29 Cambridge Ave
- Practice Address Line 2
- 29 Cambridge Ave.
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14215-4001
- Practice Country
- US
- Practice Phone
- (716) 931-9899
- Enumeration Date
- May 25, 2010
- Last Updated
- May 25, 2010
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Driver (172A00000X)