Provider Demographics
NPI:1346900198
Name:TAMAR GORDON PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:TAMAR GORDON PSYCHOLOGY PLLC
Other - Org Name:TAMAR GORDON PSYCHOLOGY PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-972-5671
Mailing Address - Street 1:125 W 72ND ST RM 4R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3278
Mailing Address - Country:US
Mailing Address - Phone:917-972-5671
Mailing Address - Fax:
Practice Address - Street 1:125 W 72ND ST RM 4R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3278
Practice Address - Country:US
Practice Address - Phone:917-972-5671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty