Provider Demographics
NPI:1548203516
Name:TURK, GERALD E (NPP-C)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:E
Last Name:TURK
Suffix:
Gender:M
Credentials:NPP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9077 STATE ROUTE 408
Mailing Address - Street 2:
Mailing Address - City:NUNDA
Mailing Address - State:NY
Mailing Address - Zip Code:14517-9728
Mailing Address - Country:US
Mailing Address - Phone:585-468-2173
Mailing Address - Fax:585-468-2172
Practice Address - Street 1:9077 STATE ROUTE 408
Practice Address - Street 2:
Practice Address - City:NUNDA
Practice Address - State:NY
Practice Address - Zip Code:14517-9728
Practice Address - Country:US
Practice Address - Phone:585-468-2173
Practice Address - Fax:585-468-2172
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400765363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000560995002OtherCOMMUNITY BLUE
NYW94989Medicare UPIN