Provider Demographics
NPI:1245398296
Name:GERBASI, PATRICK R (CRNA)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:R
Last Name:GERBASI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 SPRING FOREST RD STE 130
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-873-9533
Mailing Address - Fax:919-882-7913
Practice Address - Street 1:3100 SPRING FOREST RD STE 130
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2880
Practice Address - Country:US
Practice Address - Phone:919-873-9533
Practice Address - Fax:919-882-7913
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY465920367500000X
NC303945367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB4444Medicare PIN