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Individual

DR. JUDITH GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1050 FOREST HILL RD, STATEN ISLAND, NY 10314-6356
(347) 752-0586
Mailing address
292 EDINBORO RD, STATEN ISLAND, NY 10306-1254
(347) 752-0586

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
008570-1
NY
103TC2200X
Clinical Child & Adolescent Psychologist
008570-1
NY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
008570-1
NY

Other

Enumeration date
02/19/2015
Last updated
02/19/2015
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