Provider Demographics
NPI:1700353695
Name:JAMIE GORDON-KARP PSYD LLC
Entity Type:Organization
Organization Name:JAMIE GORDON-KARP PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:GORDON-KARP
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:215-964-2433
Mailing Address - Street 1:3 DORCHESTER LANE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:215-964-2433
Mailing Address - Fax:
Practice Address - Street 1:103 CARNEGIE CTR STE 300
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6235
Practice Address - Country:US
Practice Address - Phone:215-964-2433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1790891489Medicaid