MR. CARLO DISALVO GARDNER (NPI# 1366908329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366908329 |
| Entity Type | Individual |
| Full Name | MR. CARLO DISALVO GARDNER |
| Credential | PA-C |
| Practice Address |
740 High St Ste 2001 Williamsport PA 17701-3102 |
| Mailing Address |
1201 Grampian Blvd Williamsport PA 17701-1900 |
| Practice Telephone | 5703212800 |
| Practice Fax Number | 5703213351 |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | OA004760 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
740 HIGH ST STE 2001 |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-3102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427043553 | Raymond S Resnick | Internal Medicine | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2005-09-14 |
| 1508340746 | Kelsey Lee Beard | Nurse Practitioner | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2018-09-24 |
| 1033691126 | Merete Alicia Vogelsong | Nurse Practitioner | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2018-09-05 |
| 1750709259 | Christopher Enwonwu | Radiology | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2014-04-01 |
| 1235571092 | Katie Anne Petersen | Nurse Practitioner | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2013-07-22 |
| 1578903134 | Umar Tariq | Radiology | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2013-06-27 |
| 1710276944 | Renee Dallasen Muchnik | Internal Medicine | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2011-03-28 |
| 1225331184 | Casey Yossa | Surgery | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2010-12-15 |
| 1093956773 | Darcie Desiderio | Nurse Practitioner | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2009-03-10 |
| 1619946498 | Charles H. Haney IIi | Physician Assistant | 740 High St Ste 2001, Williamsport, PA 17701-3102 | 2006-03-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| 1376979534 | Geisinger Clinic | Physician Assistant | 824 E Third Street, Williamsport, PA 17701-5856 | 2013-09-19 |
| 1134469653 | Ashley Elizabeth Vanord | Physician Assistant | 1205 Grampian Blvd Ste 1d, Williamsport, PA 17701-1968 | 2013-02-20 |
| 1477793172 | Susquehanna Physician Services | Physician Assistant | 1201 Grampian Blvd Ste 1a, Williamsport, PA 17701-1965 | 2009-02-20 |
| 1437308343 | Michelle L Hartford | Physician Assistant | 1201 Grampian Blvd Ste 2f, Williamsport, PA 17701-1965 | 2008-09-16 |
| 1558373571 | Daniel Ryan Freshour | Physician Assistant | 1824 E 3rd St, Williamsport, PA 17701-3914 | 2006-08-12 |
| 1356380901 | Annette Louise Mileto | Physician Assistant | 1205 River Ave Fl 1, Williamsport, PA 17701-3724 | 2006-06-06 |
| 1467430942 | Bruce W. Body | Physician Assistant | 1824 East Third St., Williamsport, PA 17701-6063 | 2006-01-05 |
| 1952916256 | Karlye Gentzyel | Physician Assistant | 740 High St Ste 1003, Williamsport, PA 17701-3102 | 2020-09-14 |
| 1891305579 | Suhag Patel | Physician Assistant | 740 High St Ste 3002, Williamsport, PA 17701-3102 | 2020-08-06 |
| Find all providers in WILLIAMSPORT | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.