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Individual

MR. GORDON L MCCRAE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CCMA

Contact information

Practice address
714 BROADWAY, SUITE #1, PATERSON, NJ 07514-3402
(973) 357-1555
(973) 357-2640
Mailing address
714 BROADWAY, SUITE #1, PATERSON, NJ 07514-3402
(973) 357-1555
(973) 357-2640

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6622-5661
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6622-5661
NHA
NJ
Enumeration date
04/04/2008
Last updated
04/04/2008
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