Provider Demographics
NPI:1851281240
Name:ADY, JEAN-GHARDHER (PA)
Entity type:Individual
Prefix:MR
First Name:JEAN-GHARDHER
Middle Name:
Last Name:ADY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23141 128TH RD
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1310
Mailing Address - Country:US
Mailing Address - Phone:929-395-5803
Mailing Address - Fax:
Practice Address - Street 1:23141 128TH RD
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1310
Practice Address - Country:US
Practice Address - Phone:929-395-5803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant