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Individual

GINGER JEAN GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2375
Mailing address
633 3RD AVE, BOX 3, NEW YORK, NY 10017-6706

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
D62011
MD
207VX0201X
Gynecologic Oncology Physician
Primary
224188
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8RR1130601
MEDICARE PTAN
NY
01
8RR11EE101
MEDICARE PTAN
NY
Enumeration date
06/13/2006
Last updated
08/19/2011
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