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

DR. DUSTIN JOEL GORDON, PH.D.

Active Sole Proprietor

DR. DUSTIN JOEL GORDON, PH.D. is a Clinical Neuropsychologist healthcare provider located in RIDGWOOD, New Jersey. NPI 1124126404 is currently active in the NPPES registry. Verify at CMS.

Clinical Neuropsychologist · RIDGWOOD, NJ

Registration Details

NPI Number
1124126404
Provider Type
Individual
Gender
Male
NPI Issued
Sep 20, 2006 (19.941090957273 yrs)
Last Updated
Jul 8, 2007
License
3610 (NJ)
Sole Proprietor
Yes

Practice Information

Address
61 N. MAPLE AVE.
STE 103
RIDGWOOD, NJ, 07450
Browse NJ providers · Browse ZIP 07450
Phone
2016709773
Fax
9734271463
Primary Specialty
Clinical Neuropsychologist
103G00000X
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.