Provider Demographics
NPI:1528048444
Name:GARDNER, KARA LYNN (MS)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:LYNN
Last Name:GARDNER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:KARA
Other - Middle Name:GARDNER
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:22 RIVER TER
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10282-1149
Mailing Address - Country:US
Mailing Address - Phone:212-608-5292
Mailing Address - Fax:
Practice Address - Street 1:170 W 12TH ST
Practice Address - Street 2:NR925, GENETICS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-7692
Practice Address - Fax:212-604-3899
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2002119170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS