Individual provider · Type 1 NPI

Jacob Edward Gardner, MD, MPH

Student in an Organized Health Care Education/Training Program · Bronx, NY

NPI number 1134973266 Active

Practice location

111 E 210th St
Bronx, NY 10467-2401

Call (718) 920-4800 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1134973266

Jacob Edward Gardner, MD, MPH's National Provider Identifier is 1134973266, issued on Apr 15, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Bronx, NY. The record was last updated on Mar 31, 2025.