National Provider Identifier

Alyssa Gardner

Alyssa Gardner is listed in the NPPES registry with a primary specialty of Sports Medicine (Physical Medicine & Rehabilitation) Physician in Kenmore, NY and a listed phone number of (716) 803-0115.

NPI 1013642081Kenmore, NYSports Medicine (Physical Medicine & Rehabilitation) Physician

Profile Overview

NPI
1013642081
Provider Type
Individual
Primary Specialty
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Enumeration Date
July 22, 2022
Last Updated
July 22, 2022

Practice Location

  • 40 Goodyear Road
  • Kenmore, NY 14217-1421

Phone: (716) 803-0115

Mailing Address

  • 2933 Delaware Ave Apt 4
  • Kenmore, NY 14217-2336

Specialties

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician (2081S0010X)
Full Record
NPI
1013642081
Entity Type
Individual
Last Name
Gardner
First Name
Alyssa
Mailing Street Address
2933 Delaware Ave Apt 4
Mailing City
Kenmore
Mailing State
NY
Mailing ZIP Code
14217-2336
Mailing Country
US
Mailing Phone
(716) 803-0115
Practice Street Address
40 Goodyear Road
Practice City
Kenmore
Practice State
NY
Practice ZIP Code
14217-1421
Practice Country
US
Practice Phone
(716) 803-0115
Enumeration Date
July 22, 2022
Last Updated
July 22, 2022
Sex
Female
Sole Proprietor
Yes
Certification Date
July 12, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Sports Medicine (Physical Medicine & Rehabilitation) Physician (2081S0010X)