Individual
BE'IANKA JAZZ'E TAYLOR GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
819 ALEXANDER RD, PRINCETON, NJ 08540-6303
(609) 759-7454
(609) 452-0627
Mailing address
51 MIDDLE ROSE ST, TRENTON, NJ 08618-3803
(609) 917-4774
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP07101900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251S0000X
—
NJ
Enumeration date
12/26/2019
Last updated
12/27/2019
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