Provider Demographics
NPI:1467449256
Name:GERSTEIN, MATTHEW I (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:I
Last Name:GERSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:711 LAWN AVE
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1575
Mailing Address - Country:US
Mailing Address - Phone:215-257-1050
Mailing Address - Fax:215-257-3026
Practice Address - Street 1:711 LAWN AVE
Practice Address - Street 2:BLDG 2
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1575
Practice Address - Country:US
Practice Address - Phone:215-257-1050
Practice Address - Fax:215-257-3026
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD073542L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010161510001Medicaid
PAI05544Medicare UPIN
PA078714J4BMedicare ID - Type Unspecified