NPI 1124126404

Dustin Joel Gordon, PHD

Practitioner Clinical Neuropsychologist Ridgwood, NJ

Practice location

Address: 61 N. Maple Ave. STE 103, Ridgwood, NJ 07450
Phone: (201) 670-9773
Fax: (973) 427-1463

Registered specialties

Clinical Neuropsychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103G00000X Licence 3610 (NJ)

Other Clinical Neuropsychologist providers in New Jersey →

Registry record

NPI: 1124126404
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Sep 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.