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General NPI Number Information
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NPI Number | 1144263765
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Entity Type | Individual
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Provider Name | GINGER JEAN GARDNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 212-639-2375
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Fax |
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Provider Business Mailing Address
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Address Line | 633 3RD AVE BOX 3
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City | NEW YORK
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State | NY
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Zip | 10017-6706
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D62011
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 224188
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License Number State | NY
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