Individual
JAMES GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
92 JORDAN LN, STAMFORD, CT 06903-3914
(203) 273-5163
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
65397
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65397
CONNECTICUT STATE MEDICAL LICENSE
CT
Enumeration date
06/16/2014
Last updated
06/23/2020
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