Individual
JORDYN L GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6800 JERICHO TPKE, SYOSSET, NY 11791-4436
(516) 393-5966
Mailing address
222 E 39TH ST, NEW YORK, NY 10016-2777
(631) 566-8536
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
04/10/2023
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