Healthcare Provider Details

I. General information

NPI: 1588713473
Provider Name (Legal Business Name): JILL GORDON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4257 US HIGHWAY 9 BLDG. 6
FREEHOLD NJ
07728-8310
US

IV. Provider business mailing address

4257 US HIGHWAY 9 BLDG. 6
FREEHOLD NJ
07728-8310
US

V. Phone/Fax

Practice location:
  • Phone: 732-303-9660
  • Fax:
Mailing address:
  • Phone: 732-303-9660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: JILL GORDON
Title or Position: OWNER
Credential: AUD
Phone: 732-303-9660