Provider Demographics
NPI:1407183213
Name:GERSTMAN, PAMELA BETH (RD)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:BETH
Last Name:GERSTMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 DELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518
Mailing Address - Country:US
Mailing Address - Phone:516-728-2851
Mailing Address - Fax:516-284-6768
Practice Address - Street 1:8 DELL DRIVE
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518
Practice Address - Country:US
Practice Address - Phone:516-728-2851
Practice Address - Fax:516-284-6768
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY957417133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered