Organization
JASON GEORGE GORDON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON GORDON (CEO)
(908) 451-2550
Entity
Organization
Contact information
Practice address
179 DAVIS AVE, PISCATAWAY, NJ 08854-2467
(908) 451-2550
Mailing address
179 DAVIS AVE, PISCATAWAY, NJ 08854-2467
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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