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NPI Code Detail

MEDICARE: HAROLD E GARDNER CRNA

MEDICARE: HAROLD E GARDNER CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist438116NY

General Provider Information

NPI Number : 1124026653
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAROLD E GARDNER CRNA
Provider Business Mailing Address
First Line : 19 BRADHURST AVE STE 3100N
Second Line :
City : HAWTHORNE
State : NY
Zip : 10532-2140
Country : US
Telephone Number : 914-909-9018
Fax Number : 914-909-9028
Provider Business Practice Location Address
First Line : 241 NORTH RD
Second Line :
City : POUGHKEEPSIE
State : NY
Zip : 12601-1154
Country : US
Telephone Number : 845-483-5000
Fax Number : 914-909-9028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 05/26/2021

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Directions to “ HAROLD E GARDNER CRNA” Practice Location

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