Physician Compare National (NPI:1629050281)

HEALTHCARE PROVIDER: TINA MARIE GARDNER MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1629050281
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406195932
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190228000763
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GARDNER
	Individual professional last name
Provider First Name	TINA
	Individual professional first name
Provider Middle Name	MARIE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	GERIATRIC MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	HOSPITAL FOR SPECIAL CARE
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7810985637
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	70
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2150 CORBIN AVE
	Group Practice or individual's line 1 address
City	NEW BRITAIN
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	060532266
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8608274994
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y