Individual
MR. JEFFREY LOUIS GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MADISON AVE STE 2D, ELMIRA, NY 14901-3219
(607) 271-3442
(607) 271-3445
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
169951
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01437750
—
NY
01
—
141766229
TAX I.D. NUMBER
NY
01
—
26159
M.V.P. HEALTHCARE ID
NY
Enumeration date
11/17/2006
Last updated
11/24/2020
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