Provider Demographics
NPI:1871799080
Name:KAPLAN, GORDON M (MD)
Entity type:Individual
Prefix:DR
First Name:GORDON
Middle Name:M
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 RIVER RD STE 1
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1351
Mailing Address - Country:US
Mailing Address - Phone:201-710-7771
Mailing Address - Fax:201-300-0119
Practice Address - Street 1:1033 RIVER RD
Practice Address - Street 2:UNIT 1
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1351
Practice Address - Country:US
Practice Address - Phone:201-710-7771
Practice Address - Fax:201-300-0119
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA079260002086S0122X
NY24034912086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ121909Medicare PIN