| Gardner Psychiatry Llc | |
|
258 Bradley St New Haven CT 06510-1106 | |
| (203) 303-9262 | |
| (860) 672-1584 |
| Full Name | Gardner Psychiatry Llc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 258 Bradley St, New Haven, Connecticut |
| Authorized Official Name and Position | Orawan Beth Gardner (NURSE PRACTITIONER) |
| Authorized Official Contact | 2033039262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gardner Psychiatry Llc 258 Bradley St New Haven CT 06510-1106 Ph: (203) 303-9262 | Gardner Psychiatry Llc 258 Bradley St New Haven CT 06510-1106 Ph: (203) 303-9262 |
| NPI Number | 1598483455 |
|---|---|
| Provider Enumeration Date | 08/17/2022 |
| Last Update Date | 03/12/2023 |
| Certification Date | 03/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598483455 | NPI | - | NPPES |
| 004025219 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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