| Elsie M. Gordon, Ph.d., Llc | |
|
13-15 E Deer Park Dr Ste 103d Gaithersburg MD 20877-2070 | |
| (240) 750-8847 | |
| Not Available |
| Full Name | Elsie M. Gordon, Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 13-15 E Deer Park Dr Ste 103d, Gaithersburg, Maryland |
| Authorized Official Name and Position | Elsie Managbanag Gordon (PSYCHOLOGIST) |
| Authorized Official Contact | 2407508847 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elsie M. Gordon, Ph.d., Llc 13-15 E Deer Park Dr Ste 103d Gaithersburg MD 20877-2070 Ph: (240) 750-8847 | Elsie M. Gordon, Ph.d., Llc 13-15 E Deer Park Dr Ste 103d Gaithersburg MD 20877-2070 Ph: (240) 750-8847 |
| NPI Number | 1619360385 |
|---|---|
| Provider Enumeration Date | 03/05/2015 |
| Last Update Date | 03/05/2015 |
| Medicare PECOS PAC ID | 3476873514 |
|---|---|
| Medicare Enrollment ID | O20150513001637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619360385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 04451 (Maryland) | Primary |
| Provider Name | Elsie M Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003875246 PECOS PAC ID: 7113003377 Enrollment ID: I20080408000544 |
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