Provider Demographics
NPI:1285227272
Name:SITU, GERRY (PA-C)
Entity Type:Individual
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First Name:GERRY
Middle Name:
Last Name:SITU
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:12127B HWY 14 N
Mailing Address - Street 2:STE 5
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9557
Mailing Address - Country:US
Mailing Address - Phone:505-286-2396
Mailing Address - Fax:505-286-2398
Practice Address - Street 1:1851 OLD US 66
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:NM
Practice Address - Zip Code:87015-7200
Practice Address - Country:US
Practice Address - Phone:505-286-2396
Practice Address - Fax:505-286-2398
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2022-08-30
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant