Individual
ROMAINE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
4271 HEMPSTEAD TPKE, BETHPAGE, NY 11714-5708
(516) 520-6600
(516) 520-6750
Mailing address
4271 HEMPSTEAD TPKE, BETHPAGE, NY 11714-5708
(516) 520-6600
(516) 520-6750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17613
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17613
CERTAFIDE ALCOHOL AND SUBSTANCE COUNSELOR
NY
Enumeration date
01/23/2013
Last updated
01/23/2013
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