IndividualActive
Dustin Gordon, PH.D.
NPI 1124126404 · Clinical Neuropsychologist · Ridgwood, NJ
Provider details
- NPI number
- 1124126404
- Entity type
- Individual
- Primary specialty
- Clinical NeuropsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 3610 (NJ)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
61 N. Maple Ave.
Ste 103
Ridgwood, NJ 07450
Phone: (201) 670-9773
Fax: (973) 427-1463
Approximate (ZIP-level) locationGet directions
Mailing address
61 N. Maple Ave.
Ridgwood, NJ 07450
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.