DR. DUSTIN JOEL GORDON PH.D. NPI 1124126404

NPI Information

DR. Dustin Joel Gordon, PH.D. is a clinical neuropsychologist in Ridgwood, NJ with 28 years of experience. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. DR. Dustin Joel Gordon, PH.D. NPI is 1124126404. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

61 N. MAPLE AVE.
STE 103
RIDGWOOD, NJ
ZIP 07450
Phone: (201) 670-9773
Fax: (973) 427-1463

The NPI 1124126404 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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