Laurie Elise Gordon, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

204694 Issued in NY

Practice address

14 E 4TH St Apt 401
New York, NY 10012-1141

Phone

(212) 358-1881

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2014 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720155930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 24TH ST APT 505",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103806",
            "telephone_number": "212-679-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 E 4TH ST APT 401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121141",
            "telephone_number": "212-358-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LAURIE",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "204694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• June Gordon
• Kiplin Tony Gordon, NP
• Lance D Gordon, DMD
• Lara Gordon, M.D.
• Laurie Gordon, MD
• Leslie Ellen Gordon, MD
• Lydia Gordon, LMSW
• Lynn Y Gordon, LCSW
• Mackenzie C Gordon, RN
• Madeline Gordon, PSYD

• Child & Adolescent Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.