Provider Demographics
NPI:1477711752
Name:GARDNER, ELIZABETH CARPENTER (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CARPENTER
Last Name:GARDNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:800 HOWARD AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1369
Mailing Address - Country:US
Mailing Address - Phone:203-747-4405
Mailing Address - Fax:203-688-5599
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:T-209
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2259
Practice Address - Fax:203-688-5599
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2013-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT051754207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine