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NPI Code Detail

MEDICARE: GARDNER FAMILY MEDICINE, INC.

MEDICARE: GARDNER FAMILY MEDICINE, INC.
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
1207Q00000XFamily Medicine Physician2141244MA
2363A00000XPhysician Assistant214124MA

General Provider Information

NPI Number : 1003011594
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARDNER FAMILY MEDICINE, INC.
Provider Business Mailing Address
First Line : 57 CITY HALL AVE
Second Line :
City : GARDNER
State : MA
Zip : 01440-2614
Country : US
Telephone Number : 978-630-3862
Fax Number : 978-630-4176
Provider Business Practice Location Address
First Line : 57 CITY HALL AVE
Second Line :
City : GARDNER
State : MA
Zip : 01440-2614
Country : US
Telephone Number : 978-630-3862
Fax Number : 978-630-4176
Authorized Official
Title or Position : PRESIDENT
Name : JENNIFER RYAN
Credential : DO
Telephone Number : 978-630-3862
Provider Enumeration Date : 06/15/2007
Last Update Date : 09/11/2025

Similar Medicare Providers

1467427708 — JENNIFER RYAN D.O.
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
Practice Phone: 978-630-3862
Practice Fax: 978-630-4176
1386610863 — AMANDA SPADAZZI M.D.
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
Practice Phone: 978-630-3862
Practice Fax: 978-630-4176
1962577262 — MR. MATTHEW J ENOS PA
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
Practice Phone: 978-630-3862
Practice Fax: 978-630-4176
1730225582 — DR. JEFFREY D MOSER D.P.M.
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
Practice Phone: 978-630-3862
Practice Fax:
1992201925 — ERIK WILLIAM WISNIEWSKI FNP
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
Practice Phone: 978-630-3862
Practice Fax:
1104541432 — MISS CHELSEA LEE GAGNE FNP-C
Practice Location Address:
57 CITY HALL AVE
GARDNER, MA
01440-2614
Practice Phone: 978-630-3862
Practice Fax: 978-630-4176

Directions to “GARDNER FAMILY MEDICINE, INC. ” Practice Location

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