Provider Demographics
NPI:1518993773
Name:GERSH, FRANK SUTTON (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:SUTTON
Last Name:GERSH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 ROCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-3125
Mailing Address - Country:US
Mailing Address - Phone:319-338-9960
Mailing Address - Fax:319-338-9492
Practice Address - Street 1:1027 ROCHESTER AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-3125
Practice Address - Country:US
Practice Address - Phone:319-338-9960
Practice Address - Fax:319-338-9492
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA330103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
02691Medicare ID - Type Unspecified
R02805Medicare UPIN