PETA-GAYE TISHA GORDON

MEDFORD, NY
NPI1053645341
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: NY  629991)
Additional Taxonomies164W00000X Licensed Practical Nurse
(Licence: NY  279643-1)
Enumeration Date2009-09-20
Last Update Date2024-04-15
Business Address
Ms. PETA-GAYE TISHA GORDON
127 MAPLE LN
MEDFORD, NY 11763-1027
Phone number: 631-576-5833
Mailing Address
Ms. PETA-GAYE TISHA GORDON
127 MAPLE LN
MEDFORD, NY 11763-1027
Phone number: 631-576-5833