Provider Demographics
NPI:1376882464
Name:DANOSOS, GERARD N (DO)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:N
Last Name:DANOSOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4490 MOUNT ROYAL BLVD STE 3100
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2685
Mailing Address - Country:US
Mailing Address - Phone:412-219-1173
Mailing Address - Fax:412-219-1174
Practice Address - Street 1:4490 MOUNT ROYAL BLVD STE 3100
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2685
Practice Address - Country:US
Practice Address - Phone:412-219-1173
Practice Address - Fax:412-219-1174
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY300565207N00000X
NY016380363A00000X
PAOS021845207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400084757Medicare PIN