Provider Demographics
NPI:1457669574
Name:GERACI, GINA A (RPA-C)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:A
Last Name:GERACI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 S CLINTON AVE STE 610
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5723
Mailing Address - Country:US
Mailing Address - Phone:585-244-3430
Mailing Address - Fax:585-244-3165
Practice Address - Street 1:1815 S CLINTON AVE STE 610
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5723
Practice Address - Country:US
Practice Address - Phone:585-244-3430
Practice Address - Fax:585-244-3165
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014279363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant