Provider Demographics
NPI:1518227099
Name:GERBER, SHARON RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:RUTH
Last Name:GERBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8441
Mailing Address - Country:US
Mailing Address - Phone:631-396-7000
Mailing Address - Fax:631-396-7026
Practice Address - Street 1:376 E MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8441
Practice Address - Country:US
Practice Address - Phone:631-396-7000
Practice Address - Fax:631-396-7026
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280167207VC0300X
NY280167-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VC0300XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyComplex Family Planning
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04805143Medicaid