Individual
MELANIE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
924 DE MOTT AVE, NORTH BALDWIN, NY 11510-1925
(516) 508-8725
Mailing address
924 DE MOTT AVE, NORTH BALDWIN, NY 11510-1925
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002648-1
NY
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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