Derrick M Gordon, PHD
Psychologist, Clinical in New Haven, Connecticut
1730690835- Practice location
- 389 Whitney Ave, New Haven, CT 06511-2301
- Phone
- 203-789-7645
- Fax
- 203-562-6355
- Last updated
- October 16, 2017
Derrick M Gordon is a Psychologist, Clinical based in New Haven, CT. Derrick M Gordon practices in New Haven, CT and has the professional credentials of PHD. The NPI Number for Derrick M Gordon is 1730690835 and holds a License No. 003297 (CT). The current practice location address for Derrick M Gordon is 389 Whitney Ave, New Haven, CT 06511-2301 and can be reached out via phone at 203-789-7645 and via fax at 203-562-6355.
Provider Profile Details
- NPI Number
- 1730690835
- Provider Name
- Derrick M Gordon
- Credential
- PHD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 389 Whitney Ave, New Haven, CT 06511-2301
- Phone Number
- 203-789-7645
- Fax Number
- 203-562-6355
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- October 16, 2017
- Last Update Date
- October 16, 2017
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 389 Whitney Ave
New Haven, CT 06511-2301 - City
- New Haven
- State
- Connecticut
- Zip
- 06511-2301
- Phone Number
- 203-789-7645
- Fax Number
- 203-562-6355
Provider Business Mailing Address Details
- Address
- 44 Old Quarry RD
Woodbridge, CT 06525-1006 - City
- Woodbridge
- State
- CT
- Zip
- 06525-1006
- Phone Number
- 203-675-4228
License Information
- License Number
- 003297
- License State
- CT
- Taxonomy
- Psychologist, Clinical · 103TC0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Derrick M Gordon, PHD?
The NPI number of Derrick M Gordon, PHD is 1730690835. It was assigned on October 16, 2017 and is currently active in the NPPES registry.
What is the specialty of Derrick M Gordon, PHD?
Derrick M Gordon, PHD is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in CT under license number 003297.
Where does Derrick M Gordon, PHD practice?
The practice location is 389 Whitney Ave, New Haven, CT 06511-2301. The office can be reached at 203-789-7645 (phone) or 203-562-6355 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1730690835 directly on the NPPES registry website.