Healthcare Provider Details

I. General information

NPI: 1780995050
Provider Name (Legal Business Name): EMILY JOAN GARBER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 MAIN ST STE 7L
TRUMBULL CT
06611-1389
US

IV. Provider business mailing address

5775 75TH ST APT 1
MIDDLE VILLAGE NY
11379-5260
US

V. Phone/Fax

Practice location:
  • Phone: 203-551-4173
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4390
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4390
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number88194
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: