Active NPI
Lawrence Paul Gordon, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Syracuse, NY
National Provider Identifier
1154314185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 114226
- Practice address
- 736 Irving Ave
9TH FL
Syracuse, NY 13210-1687 - Phone
- (315) 470-7396
- Fax
- (315) 470-2806
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | 114226 | NY | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 114226 | NY | Primary |
| Pediatric Pathology Physician | 207ZP0213X | 114226 | NY |
Addresses
Primary practice location
736 Irving Ave
9TH FL
Syracuse, NY 13210-1687
Mailing address
4567 Crossroads Park Dr
2ND FL
Liverpool, NY 13088-3589
Phone (315) 434-9309
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114226 | NY | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology Associates of Syracuse, PC | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Cytology Associates of Cny PLLC | Past | Accepting new patients |
Locations
150 Broad St
Hamilton, NY 13346
Phone (315) 824-1100
736 Irving Ave
Fl 9
Syracuse, NY 13210
Phone (315) 470-7396
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anatomic Pathology & Clinical Pathology Physician
- Syracuse, NY
- NPI 1629061791
-
- Cytopathology Physician
- Syracuse, NY
- NPI 1629231204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1154314185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4567 CROSSROADS PARK DR",
"address_2": "2ND FL",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130883589",
"telephone_number": "315-434-9309",
"fax_number": "315-454-0136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 IRVING AVE",
"address_2": "9TH FL",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101687",
"telephone_number": "315-470-7396",
"fax_number": "315-470-2806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LAWRENCE",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0007X",
"taxonomy_group": "",
"desc": "Pathology, Molecular Genetic Pathology",
"state": "NY",
"license": "114226",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NY",
"license": "114226",
"primary": true
},
{
"code": "207ZP0213X",
"taxonomy_group": "",
"desc": "Pathology, Pediatric Pathology",
"state": "NY",
"license": "114226",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.