Individual
MS. DONNA LEE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1163 JERICHO TPKE, COMMACK, NY 11725-3001
(631) 543-3331
Mailing address
1163 JERICHO TPKE, COMMACK, NY 11725-3001
(631) 543-3331
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
140101489624997
NY
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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