Provider Demographics
NPI:1558356790
Name:GERLAND, JEFFREY S (DPM)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:GERLAND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:JEFFREY
Other - Middle Name:S
Other - Last Name:GERLAND
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:104 1/2 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2220
Mailing Address - Country:US
Mailing Address - Phone:610-664-1070
Mailing Address - Fax:610-664-6853
Practice Address - Street 1:104 1/2 FORREST AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2220
Practice Address - Country:US
Practice Address - Phone:610-664-1070
Practice Address - Fax:610-664-6853
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC 2589L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GE432234Medicare ID - Type Unspecified
T30393Medicare UPIN