Provider Demographics
NPI:1053674937
Name:GERSHENSON, ALINA (MS,ED,SPED)
Entity Type:Individual
Prefix:MRS
First Name:ALINA
Middle Name:
Last Name:GERSHENSON
Suffix:
Gender:F
Credentials:MS,ED,SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 OCEANA DR W
Mailing Address - Street 2:7D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6665
Mailing Address - Country:US
Mailing Address - Phone:917-655-0408
Mailing Address - Fax:
Practice Address - Street 1:40 OCEANA DR W
Practice Address - Street 2:7D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6665
Practice Address - Country:US
Practice Address - Phone:917-655-0408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-16
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY790478174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator