Individual
DR. WILLIAM MICHAEL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
224 LORRAINE AVE, UPPER MONTCLAIR, NJ 07043-1915
(973) 744-8791
Mailing address
224 LORRAINE AVE, UPPER MONTCLAIR, NJ 07043-1915
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35S100122800
NJ
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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