Provider Demographics
NPI:1245246396
Name:GERBER, JEFFREY (DPM, PC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:GERBER
Suffix:
Gender:M
Credentials:DPM, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6716
Mailing Address - Country:US
Mailing Address - Phone:516-921-5949
Mailing Address - Fax:516-921-1233
Practice Address - Street 1:87 COLD SPRING RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3150
Practice Address - Country:US
Practice Address - Phone:516-921-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002849213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20-0116141OtherHEALTHNET
NY36583POtherHIP
NYP31881OtherBLUE CROSS/ BLUE SHIELD
NYD02127OtherOXFORD HEALTH PLANS
NY20-0116141Other1199 NATIONAL BENEFIT PL.
NY20-0116141OtherUHC/EMPIRE
NY480021883OtherRAILROAD MEDICARE
NY6299016OtherGHI
NY00405041Medicaid
NYS540051OtherSUFFOLK HEALTH
NY25152OtherVYTRA
NY20-0116141OtherAETNA
NYS540051OtherSUFFOLK HEALTH
NY25152OtherVYTRA