Individual
ANDREW GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
45 READE PL, POUGHKEEPSIE, NY 12601-3947
(845) 483-6217
(845) 483-6108
Mailing address
45 READE PL, POUGHKEEPSIE, NY 12601-3947
(845) 483-6217
(845) 483-6108
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
003948-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01551115
—
NY
Enumeration date
06/29/2006
Last updated
07/08/2007
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