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General NPI Number Information
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NPI Number | 1437203163
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Entity Type | Individual
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Provider Name | ANDREA D GORDON LCSWR
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 325 MANVILLE RD
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City | PLEASANTVILLE
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State | NY
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Zip | 10570-2122
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Country | US
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Telephone | 914-656-4470
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Fax |
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Provider Business Mailing Address
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Address Line | 8 BRIARCLIFF DR S 15
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City | OSSINING
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State | NY
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Zip | 10562-2343
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Country | US
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Telephone | 914-656-4470
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R026296
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License Number State | NY
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