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Contact Information

RANDALL GORDON JR
30 PARK AVE APT 1L
MOUNT VERNON, NY10550-2151
 Phone: 347-341-9334
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Driver

172A00000X
 

Personal Care Attendant

3747P1801X
Indicates primary specialty

NPI Profile & details for RANDALL GORDON JR · (Male)

NPI Number 1467141531
Status Active
Credentials
Entity Individual
Enumeration date 05/04/2023
Last updated 05/04/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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