Provider Demographics
NPI:1457677213
Name:HARDIN, GREGORY JACK (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JACK
Last Name:HARDIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:50 DAYTON LANE, SUITE 202
Mailing Address - Street 2:THE WESTCHESTER MEDICAL PRACTICE PC
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:1980 CROMPOND ROAD
Practice Address - Street 2:THE WESTCHESTER MEDICAL PRACTICE PC
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567
Practice Address - Country:US
Practice Address - Phone:914-734-3600
Practice Address - Fax:914-734-3601
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2023-12-08
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY271063208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program