Provider Demographics
NPI:1548227309
Name:GERSHENBAUM, ERIC ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ANDREW
Last Name:GERSHENBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:509 STILLWELLS CORNER RD
Mailing Address - Street 2:SUITE E5
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2965
Mailing Address - Country:US
Mailing Address - Phone:732-431-9333
Mailing Address - Fax:732-431-3312
Practice Address - Street 1:509 STILLWELLS CORNER RD
Practice Address - Street 2:SUITE E5
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2965
Practice Address - Country:US
Practice Address - Phone:732-431-9333
Practice Address - Fax:732-431-3312
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07781000207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ201262468OtherQUALCARE
NJOXFORDOtherP3547665
NJ278080OtherAMERIGROUP
NJNJ7810OtherEYEMED
NJ201262468OtherMULTIPLAN
NJ2392563000OtherAMERIHEALTH
NJ0979343OtherCIGNA
NJ201262468OtherVISION SERVICE PLAN
NJ3627031OtherAETNA
NJ0053023Medicaid
NJ1877842OtherUNITED HEALTHCARE
NJ27419OtherSPECTERA
NJ8222242OtherGHI
NJ201262468OtherHORIZON BCBS
NJ201262468OtherMAGNACARE
NJ50973OtherDAVIS VISION
NJ5641748OtherFIRST HEALTH
NJ201262468OtherMULTIPLAN
NJ5690990001Medicare NSC
NJ1877842OtherUNITED HEALTHCARE