Provider Demographics
NPI:1518229509
Name:GERSCH, MEGAN LEIGH (BS)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LEIGH
Last Name:GERSCH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-3210
Mailing Address - Country:US
Mailing Address - Phone:914-490-0738
Mailing Address - Fax:
Practice Address - Street 1:52 PANORAMA DR
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-3210
Practice Address - Country:US
Practice Address - Phone:914-490-0738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1364684174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist