Organization
GARDNER PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ORAWAN BETH GARDNER APRN (NURSE PRACTITIONER)
(203) 303-9262
Entity
Organization
Contact information
Practice address
258 BRADLEY ST, NEW HAVEN, CT 06510-1106
(203) 303-9262
(860) 672-1584
Mailing address
258 BRADLEY ST, NEW HAVEN, CT 06510-1106
(203) 303-9262
(860) 672-1584
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004025219
—
CT
Enumeration date
08/17/2022
Last updated
03/12/2023
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