Provider Demographics
NPI:1518052505
Name:GEROW, GEOFFREY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:JOHN
Last Name:GEROW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 E FERRY ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14208-1602
Mailing Address - Country:US
Mailing Address - Phone:716-882-7701
Mailing Address - Fax:716-882-7726
Practice Address - Street 1:449 E FERRY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14208-1602
Practice Address - Country:US
Practice Address - Phone:716-882-7701
Practice Address - Fax:716-882-7726
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX03219-1111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY16137088501OtherUNIVERA (PRISM HEALTH NET
NY2256355OtherBLUE CROSS/BLUE SHIELD
NYC03219-5BOtherWORKERS COMPENSATION
NY8809931OtherINDEPENDENT HEALTH
NY8809931OtherINDEPENDENT HEALTH
NY2256355OtherBLUE CROSS/BLUE SHIELD