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NPI Code Detail

MEDICARE: ERASTUS AURELIUS GARDINER MA.EDUC., MDIV.

MEDICARE:   ERASTUS AURELIUS GARDINER  MA.EDUC., MDIV.
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1821215088
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERASTUS AURELIUS GARDINER MA.EDUC., MDIV.
Provider Business Mailing Address
First Line : PO BOX 5305
Second Line :
City : CHRISTIANSTED
State : VI
Zip : 00823-5305
Country : US
Telephone Number : 340-772-5567
Fax Number : 340-772-2148
Provider Business Practice Location Address
First Line : 516 STRAND ST
Second Line :
City : FREDERIKSTED
State : VI
Zip : 00840-3533
Country : US
Telephone Number : 340-772-0260
Fax Number : 340-719-3234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 07/08/2007

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Directions to “ ERASTUS AURELIUS GARDINER MA.EDUC., MDIV.” Practice Location

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