Organization
MARA GORDON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARA JOAN GORDON P.T. (SOLE PROPRIETOR)
(917) 514-9831
Entity
Organization
Contact information
Practice address
221 NICHOLS ST, CARMEL, NY 10512-5022
(917) 514-9831
(845) 225-4034
Mailing address
221 NICHOLS ST, CARMEL, NY 10512-5022
(917) 514-9831
(845) 225-4034
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
012715
NY
Other
Enumeration date
06/02/2013
Last updated
06/02/2013
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