Provider Demographics
NPI:1003177874
Name:GERSH, ALEXANDRA
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:
Last Name:GERSH
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 1:2795 SHORE PKWY
Mailing Address - Street 2:APT 6A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6531
Mailing Address - Country:US
Mailing Address - Phone:347-414-6739
Mailing Address - Fax:
Practice Address - Street 1:1580 DAHILL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3573
Practice Address - Country:US
Practice Address - Phone:718-375-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator