Provider Demographics
NPI:1437142445
Name:GERIKE, ALBINA (CRNA)
Entity Type:Individual
Prefix:
First Name:ALBINA
Middle Name:
Last Name:GERIKE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13621 NW 12TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2808
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:844-414-8291
Practice Address - Street 1:175 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-2038
Practice Address - Country:US
Practice Address - Phone:856-325-3952
Practice Address - Fax:855-851-4405
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00259800367500000X
NJN096564367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1386654036OtherAMERICAN ANESTHESIOLOGY OF NEW JERSEY, PC