Provider Demographics
NPI:1376723536
Name:GERGES, SARWAT (BS)
Entity Type:Individual
Prefix:
First Name:SARWAT
Middle Name:
Last Name:GERGES
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-2204
Mailing Address - Country:US
Mailing Address - Phone:845-628-5299
Mailing Address - Fax:845-621-0403
Practice Address - Street 1:159 ROUTE 6
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-2204
Practice Address - Country:US
Practice Address - Phone:845-628-5299
Practice Address - Fax:845-621-0403
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist