Most Relevant Information
Provider Data
| NPI Number: | 1003397704 |
| Provider Name: | SHACORA TAWANNA GORDON |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/22/2018 |
| Last Updated: | 08/22/2018 |
Provider Practice Location
2631 MERRICK RD STE 302
BELLMORE
NY
117105784
Practice Location Phone/Fax
| Phone: | 5165907575 |
| Fax: |
Provider Mailing Location
111 BRIDGE ST APT 7B
BROOKLYN
NY
112011513
Provider Mailing Phone/Fax
| Phone: | 4754494556 |
| Fax: |