Individual
MARK GILDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3399 NORTH RD, POUGHKEEPSIE, NY 12601-1387
(845) 575-3000
Mailing address
41 HAVILAND RD, POUGHKEEPSIE, NY 12601-6613
(914) 204-0051
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001688
NY
Other
Enumeration date
09/02/2019
Last updated
09/02/2019
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