National Provider Identifier
John David Gordon, PAC
John David Gordon, PAC is listed in the NPPES registry with a primary specialty of Physician Assistant in Corning, NY and a listed phone number of (607) 684-6115.
Profile Overview
- NPI
- 1831158351
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- March 22, 2006
- Last Updated
- March 16, 2016
Practice Location
- 88 E Tioga Ave Ste 102
- 88 Tioga Avenue, Ste 102
- Corning, NY 14830-2858
Phone: (607) 684-6115
Mailing Address
- 88 E Tioga Ave Ste 102
- Smith Allergy & Asthma Of Cny PLLC
- Corning, NY 14830-2858
Specialties
- Physician Assistant (363A00000X)
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1831158351
- Entity Type
- Individual
- Last Name
- Gordon
- First Name
- John
- Middle Name
- David
- Name Prefix
- Mr.
- Credential
- PAC
- Mailing Street Address
- 88 E Tioga Ave Ste 102
- Mailing Address Line 2
- Smith Allergy & Asthma Of Cny PLLC
- Mailing City
- Corning
- Mailing State
- NY
- Mailing ZIP Code
- 14830-2858
- Mailing Country
- US
- Mailing Phone
- (607) 684-6115
- Mailing Fax
- (607) 684-6120
- Practice Street Address
- 88 E Tioga Ave Ste 102
- Practice Address Line 2
- 88 Tioga Avenue, Ste 102
- Practice City
- Corning
- Practice State
- NY
- Practice ZIP Code
- 14830-2858
- Practice Country
- US
- Practice Phone
- (607) 684-6115
- Practice Fax
- (607) 684-6120
- Enumeration Date
- March 22, 2006
- Last Updated
- March 16, 2016
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X), Physician Assistant (363A00000X)
- Other Identifiers
- J400278137 (NY, Medicare Ptan), CC9269 (PA, Rr Medicare Group), P00177089 (PA, Rr Medicare Pin), GU040061 (PA, Medicare Group)