Provider Demographics
NPI:1568424018
Name:FOTI, GERARD J (DO)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:J
Last Name:FOTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:931 E HAVERFORD RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3838
Mailing Address - Country:US
Mailing Address - Phone:610-558-1001
Mailing Address - Fax:610-558-1180
Practice Address - Street 1:931 E HAVERFORD RD STE 202
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-558-1001
Practice Address - Fax:610-558-1180
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0058007207X00000X
PAOS009073L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0467786OtherCIGNA
PA5926375OtherAETNA NON HMO
PA72565OtherGEISINGER HEALTH PLAN
PA2354664OtherAETNA HMO
PA03278001OtherCAPITAL BLUE CROSS
PA1392229OtherBLUE SHIELD
PA37497350000OtherKEYSTONE HEALTHPLAN EAST
PA1023835670001Medicaid
PA815090OtherFIRST PRIORITY HEALTH
PA5926375OtherAETNA NON HMO
PAH67093Medicare UPIN