Provider Demographics
NPI:1811916240
Name:GARDY, BART S (LCSW)
Entity type:Individual
Prefix:MR
First Name:BART
Middle Name:S
Last Name:GARDY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 MADISON AVENUE
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0809
Mailing Address - Country:US
Mailing Address - Phone:212-447-4478
Mailing Address - Fax:212-447-6037
Practice Address - Street 1:280 MADISON AVENUE
Practice Address - Street 2:SUITE 1201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0809
Practice Address - Country:US
Practice Address - Phone:212-447-4478
Practice Address - Fax:212-447-6033
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0431021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1301Medicare ID - Type Unspecified