Individual provider Active NPI

Lawrence Paul Gordon, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Syracuse, NY
National Provider Identifier
1154314185
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
114226 Issued in NY
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

Updated by the provider on Sep 12, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
114226NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Syracuse, PC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2016 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.

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.

Verify at the official NPI Registry.