Individual
MS. AMANDA R GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
121 DEKALB AVENUE, BROOKLYN, NY 11201
(718) 250-6604
Mailing address
121 DEKALB AVENUE, BROOKLYN, NY 11201
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/19/2020
Last updated
08/17/2020
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