Provider Demographics
NPI:1578297743
Name:GADON, ORLY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ORLY
Middle Name:
Last Name:GADON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 OVERLOOK AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3726
Mailing Address - Country:US
Mailing Address - Phone:516-661-1504
Mailing Address - Fax:
Practice Address - Street 1:1 OVERLOOK AVE APT 3E
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3726
Practice Address - Country:US
Practice Address - Phone:516-661-1504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018156103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist