Most Relevant Information
Provider Data
| NPI Number: | 1003823378 |
| Provider Name: | MICHAEL GORE PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 008532-1 |
Most Important Dates
| Enumeration Date: | 08/01/2006 |
| Last Updated: | 05/12/2009 |
Provider Practice Location
2818 OCEAN AVE
SUITE #1
BROOKLYN
NY
112353170
Practice Location Phone/Fax
| Phone: | 7189348484 |
| Fax: |
Provider Mailing Location
482 TENNYSON DR
STATEN ISLAND
NY
103126552
Provider Mailing Phone/Fax
| Phone: | 7183608607 |
| Fax: |