Individual
DIANA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 W 28TH ST STE 1901, NEW YORK, NY 10001-6179
(516) 670-5496
Mailing address
150 W 28TH ST STE 1901, NEW YORK, NY 10001-6179
(516) 670-5496
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
015809
NY
Other
Enumeration date
07/18/2022
Last updated
01/19/2023
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