Individual
MS. LA-TRICIA ALICIA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
23 WALNUT TER, BLOOMFIELD, NJ 07003-5025
(973) 978-1368
Mailing address
23 WALNUT TER, BLOOMFIELD, NJ 07003-5025
(973) 978-1368
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26NR21499700
NJ
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
26NR21499700
NJ
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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