Individual
TIMOTHY GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1485 E 34TH ST, BROOKLYN, NY 11234-2601
(347) 913-9447
Mailing address
1485 E 34TH ST, BROOKLYN, NY 11234-2601
(347) 913-9447
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
324886
NY
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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