Dorett Beverly Gordon
Licensed Practical Nurse in Bronx, NY. Individual provider (NPI-1).
NPI number1457598484
StatusActive
Last updated in NPPESNov 29, 2010
Details
- NPI
- 1457598484
- Entity type
- Individual (NPI-1)
- Name
- Dorett Beverly Gordon
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 13, 2009
- Last updated
- Nov 29, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 294307-1 | NY | Yes |
Practice location
50 W Gun Hill RdApt 4g
Bronx, NY 10467-1016
Phone 561-568-8687
Mailing address
Po Box 1011Bronx, NY 10467-0726
Phone 561-568-8687
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 1,770 Licensed Practical Nurse providers in Bronx · All 38,045 providers in Bronx
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