Provider Demographics
NPI:1518952696
Name:HECKER, GERALD A (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:A
Last Name:HECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5323
Mailing Address - Country:US
Mailing Address - Phone:212-501-7258
Mailing Address - Fax:
Practice Address - Street 1:98 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5323
Practice Address - Country:US
Practice Address - Phone:212-501-7258
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098253207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00167015Medicaid
538591Medicare ID - Type Unspecified
B16205Medicare UPIN