Provider Demographics
NPI:1023219474
Name:DR.ROY F.GHERARDI
Entity Type:Organization
Organization Name:DR.ROY F.GHERARDI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:GHERARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-671-5858
Mailing Address - Street 1:8 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1310
Mailing Address - Country:US
Mailing Address - Phone:516-671-5858
Mailing Address - Fax:516-671-8753
Practice Address - Street 1:8 GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-1310
Practice Address - Country:US
Practice Address - Phone:516-671-5858
Practice Address - Fax:516-671-8753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021472122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty