Individual
JESSICA BAKER-GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 GAZZOLA DR, EAST PATCHOGUE, NY 11772-4952
(347) 351-4437
Mailing address
640 GAZZOLA DR, EAST PATCHOGUE, NY 11772-4952
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
406871
NY
Other
Enumeration date
03/19/2025
Last updated
03/23/2025
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