Individual
MR. ANDRE LESLIE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSE
Contact information
Practice address
1516 BERGEN ST APT 3, BROOKLYN, NY 11213-1783
(347) 915-1112
Mailing address
2380 PITKIN AVE # 2, BROOKLYN, NY 11207-3824
(347) 641-0343
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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