Provider Demographics
NPI:1235179813
Name:GERSON, RONALD L (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:GERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:403 COMMERCE LN STE 3
Mailing Address - Street 2:
Mailing Address - City:WEST BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08091-2513
Mailing Address - Country:US
Mailing Address - Phone:856-767-8787
Mailing Address - Fax:856-767-6140
Practice Address - Street 1:403 COMMERCE LN STE 3
Practice Address - Street 2:
Practice Address - City:WEST BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08091-2513
Practice Address - Country:US
Practice Address - Phone:856-767-8787
Practice Address - Fax:567-676-1408
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44288207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2228700Medicaid
NJ197447BYHMedicare PIN
NJ2228700Medicaid