Provider Demographics
NPI:1538058375
Name:GIRDNER, KEARA R
Entity type:Individual
Prefix:
First Name:KEARA
Middle Name:R
Last Name:GIRDNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 WARREN ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3479
Mailing Address - Country:US
Mailing Address - Phone:703-992-4303
Mailing Address - Fax:
Practice Address - Street 1:506 WARREN ST APT 4B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3479
Practice Address - Country:US
Practice Address - Phone:703-992-4303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency