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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. PETA-GAYE TISHA GORDON

Active Sole Proprietor

MS. PETA-GAYE TISHA GORDON is a Registered Nurse healthcare provider located in MEDFORD, New York. NPI 1053645341 is currently active in the NPPES registry. Verify at CMS.

Registered Nurse · MEDFORD, NY

Registration Details

NPI Number
1053645341
Provider Type
Individual
Gender
Female
NPI Issued
Sep 20, 2009 (16.914371186001 yrs)
Last Updated
Apr 15, 2024
Licenses
279643-1 (NY)
629991 (NY)
Sole Proprietor
Yes

Practice Information

Address
127 MAPLE LN
MEDFORD, NY, 117631027
Browse NY providers · Browse ZIP 11763
Phone
6315765833
Primary Specialty
Registered Nurse
163W00000X
Additional Specialty
Registered Nurse

Other Registered Nurse Providers in MEDFORD, NY

Name Credential NPI
MR. JOSEPH COTTIERS R.N. 1336348473
MS. JULAINE MARIE APREA RN 1699950444
MRS. KUDIRAT OLUFUNKE ADESANYA REGISTERED NURSE 1043489651
MRS. ALLISON CHRISTINE LAFRANCA LPN 1376706986
LORIANN SURDOW R.N. 1659527752
MISS SUZANNE A TULLON RN 1407005622
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.