Provider Demographics
NPI:1508034976
Name:JOANN GERSTEIN R N F A P A
Entity Type:Organization
Organization Name:JOANN GERSTEIN R N F A P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-845-1717
Mailing Address - Street 1:PO BOX 1011
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-1011
Mailing Address - Country:US
Mailing Address - Phone:561-840-7578
Mailing Address - Fax:561-845-1717
Practice Address - Street 1:2151 45TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2026
Practice Address - Country:US
Practice Address - Phone:561-840-7578
Practice Address - Fax:561-863-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000Y3436AMedicare PIN