Provider Demographics
NPI:1407806755
Name:GERARDI, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:GERARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6002
Mailing Address - Country:US
Mailing Address - Phone:518-393-2070
Mailing Address - Fax:518-393-3913
Practice Address - Street 1:1532 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-6002
Practice Address - Country:US
Practice Address - Phone:518-393-2070
Practice Address - Fax:518-393-3913
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153290207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10000748OtherCDPHP
NY15137OtherMVP
NY00795217Medicaid
NYRA5799Medicare PIN
B82078Medicare UPIN