Provider Demographics
NPI:1477556975
Name:GERO, TIBOR (MD)
Entity Type:Individual
Prefix:
First Name:TIBOR
Middle Name:
Last Name:GERO
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:ERPG EMERGENCY SERVICES
Mailing Address - Street 2:763 JOHNSONBURG ST
Mailing Address - City:ST. MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857
Mailing Address - Country:US
Mailing Address - Phone:814-788-8596
Mailing Address - Fax:814-788-8036
Practice Address - Street 1:ERPG EMERGENCY SERVICES
Practice Address - Street 2:763 JOHNSONBURG ST
Practice Address - City:ST. MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857
Practice Address - Country:US
Practice Address - Phone:814-788-8596
Practice Address - Fax:814-788-8036
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041392E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE13025Medicare UPIN
PA549478Medicare ID - Type Unspecified