Individual
DEANA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 638-1000
Mailing address
147 DEER RUN, WADING RIVER, NY 11792-1703
(631) 258-5691
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F344791-01
NY
Other
Enumeration date
07/15/2019
Last updated
02/17/2024
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