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Individual

DR. ANGELA E GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1224 STATE ROUTE 29, GREENWICH, NY 12834-6120
(518) 692-2040
(518) 692-2440
Mailing address
1224 STATE ROUTE 29, GREENWICH, NY 12834-6120
(518) 692-2040
(518) 692-2440

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
005918
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000493529005
BSNENY
NY
01
10032211
CDPHP
NY
01
784431
MVP
NY
01
C2T601
EMPIRE BC
NY
Enumeration date
05/16/2006
Last updated
09/20/2019
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