Provider Demographics
NPI:1093892861
Name:GERSH, WAYNE DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:DAVID
Last Name:GERSH
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:77 TARRYTOWN RD
Mailing Address - Street 2:WESTCHESTER CENTER FOR BEHAVIOR THERAPY
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1639
Mailing Address - Country:US
Mailing Address - Phone:914-948-1411
Mailing Address - Fax:914-948-1809
Practice Address - Street 1:77 TARRYTOWN RD
Practice Address - Street 2:WESTCHESTER CENTER FOR BEHAVIOR THERAPY
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1639
Practice Address - Country:US
Practice Address - Phone:914-948-1411
Practice Address - Fax:914-948-1809
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY006282103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV29861Medicare ID - Type UnspecifiedAH