Healthcare Provider Details

I. General information

NPI: 1447179387
Provider Name (Legal Business Name): KAMILLE ABAGAIL GORDON MA.,CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8212 151ST AVE
HOWARD BEACH NY
11414-1793
US

IV. Provider business mailing address

11926 225TH ST
CAMBRIA HEIGHTS NY
11411-2116
US

V. Phone/Fax

Practice location:
  • Phone: 718-848-0300
  • Fax:
Mailing address:
  • Phone: 917-331-5144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: