Individual
MICHAEL GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-3145
(315) 464-3163
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-3145
(315) 464-3163
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5965
NY
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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