| Doctor Name: | DONALD T GARDINER |
| NPI Number: | 1164520185 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.C.S.W.R. |
| License Number: | 34577R |
| Business Practice Address: | 5800 Heritage Landing Dr Suite E East Syracuse, NY - 130579378 |
| Business Phone Number: | 3154727885 |
| Business Fax Number: | 3154722513 |
| Mailing Address: | 5800 Heritage Landing Dr, Suite E EAST SYRACUSE |
| State: | NY |
| Postal Code: | 130579378 |
| Phone Number: | 3154727885 |
| Fax Number: | 3154722513 |
| NPI Enumeration Date: | 09/21/2006 |
| NPI Last Update Date: | 03/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34577R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |