Gordon, Angela

Gordon, Angela is an individual health care provider with primary practice located at 56 Bay St Fl 6 , Staten Island NY 10301-2563. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Gordon, Angela can be contacted via phone (718) 808-1428.

Contact Information

Primary practice address
56 Bay St Fl 6 Staten Island NY 10301-2563
Phone: (718) 808-1428
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 21007 New York

Profile Details

NPI number 1487027082
LBN Legal business name Gordon, Angela
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2015
Last updated Nov 4th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487027082 NPPES
New York MEDICAID 02521240

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