Individual
DR. ALAN HOWARD GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
45 WALPOLE ST, STE 6, NORWOOD, MA 02062-3319
(781) 769-1646
(781) 769-4696
Mailing address
45 WALPOLE ST, STE 6, NORWOOD, MA 02062-3319
(781) 769-1646
(781) 769-4696
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2572
MA
103TC0700X
Clinical Psychologist
2572
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0520896
—
MA
01
—
109343
MAGELLAN BEHAVIORAL HEALT
MA
01
—
719788
TUFTS HEALTH PLAN
MA
01
—
W02873
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/05/2006
Last updated
11/29/2017
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