Individual
DESTINEE DANAE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2874 RT 17M, NEW HAMPTON, NY 10958
(845) 374-8700
Mailing address
203 GENUNG ST APT 409, MIDDLETOWN, NY 10940-2560
(917) 627-2897
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
948052
NY
Other
Enumeration date
04/18/2025
Last updated
04/18/2025
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