Provider Demographics
NPI:1508191008
Name:GERVER, ANASTASIA JOY (LPN)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:JOY
Last Name:GERVER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ANASTASIA
Other - Middle Name:JOY
Other - Last Name:PINKHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:33 OAKTREE LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1520
Mailing Address - Country:US
Mailing Address - Phone:631-334-2867
Mailing Address - Fax:
Practice Address - Street 1:33 OAKTREE LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1520
Practice Address - Country:US
Practice Address - Phone:631-334-2867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274186164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse