Provider Demographics
NPI:1821215088
Name:GARDINER, ERASTUS AURELIUS (MAEDUC, MDIV)
Entity Type:Individual
Prefix:
First Name:ERASTUS
Middle Name:AURELIUS
Last Name:GARDINER
Suffix:
Gender:M
Credentials:MAEDUC, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5305
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-5305
Mailing Address - Country:US
Mailing Address - Phone:340-772-5567
Mailing Address - Fax:340-772-2148
Practice Address - Street 1:516 STRAND ST
Practice Address - Street 2:
Practice Address - City:FREDERIKSTED
Practice Address - State:VI
Practice Address - Zip Code:00840-3533
Practice Address - Country:US
Practice Address - Phone:340-772-0260
Practice Address - Fax:340-719-3234
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health