Marilyn L Gordon, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA06003000 Issued in NJ

Practice address

817 Federal St
Camden, NJ 08103-1539

Phone

(856) 541-8217

Fax

(856) 541-4611

NPI assigned

Jun 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1174562896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 FEDERAL ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031539",
            "telephone_number": "856-541-5933",
            "fax_number": "856-541-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 FEDERAL ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031539",
            "telephone_number": "856-541-8217",
            "fax_number": "856-541-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MARILYN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06003000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6529500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Srihari Gopal, MD
• Stephen Thomas Gorda, DPM
• Candace Marie Gordon, PA-C
• Heidi V Gordon, MD
• Mara Gordon, MD
• Sabrina R Gordon, MD
• Stuart L Gordon, M.D.
• Jason Goslin, PA-C
• Jessica Goss, MA CCC-SLP
• Irene V Gottlob, MD

• Internal Medicine Physician in Camden, NJ
• Providers in Camden, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.