| Organization Name: | ANN E. GORDON MA SPEECH-LANGUAGE PATHOLOGIST PC |
| NPI Number: | 1114159464 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANN E. GORDON (PRESIDENT) |
| Mailing Address: | 207 Hallock Rd Suite 6 Stony Brook |
| State: | NY US |
| Postal Code: | 117903033 |
| Phone Number: | 6317513838 |
| Fax Number: | 6317513767 |
| NPI Enumeration Date: | 08/20/2009 |
| NPI Last Update Date: | 08/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 000469 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |