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Individual

RUBY GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
24 N CLOVER DR, GREAT NECK, NY 11021-1038
(310) 801-7893
Mailing address
24 N CLOVER DR, GREAT NECK, NY 11021-1038
(310) 801-7893

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
213E00000X
Podiatrist
N007041
NY
213EP0504X
Public Medicine Podiatrist
N007041
NY
213EP1101X
Primary Podiatric Medicine Podiatrist
N007041
NY
213ER0200X
Radiology Podiatrist
N007041
NY
213ES0000X
Sports Medicine Podiatrist
N007041
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N007041
NY
213ES0131X
Foot Surgery Podiatrist
N007041
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/16/2017
Last updated
01/04/2023
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