Provider Demographics
NPI:1851667752
Name:GORDON, HILLARY (MD)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E LANCASTER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:610-642-0245
Practice Address - Street 1:233 E LANCASTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2395
Practice Address - Country:US
Practice Address - Phone:610-642-1643
Practice Address - Fax:610-642-0245
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00122182080P0201X
PAMD4545582080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGMedicaid
DEPENDINGMedicaid