Individual
CLARK P GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 HAWLEY ST, BINGHAMTON, NY 13901-3102
(607) 778-1131
(607) 778-1164
Mailing address
757 BOSWELL HILL RD, ENDICOTT, NY 13760-6612
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
113422
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06000113422
—
NY
01
—
10061793
CDPHP
NY
Enumeration date
07/10/2006
Last updated
07/08/2007
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