Provider Demographics
NPI:1588178883
Name:GERARD, ROBERT VINCENT (METAPHYSIC PSYCHOLOG)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:VINCENT
Last Name:GERARD
Suffix:
Gender:M
Credentials:METAPHYSIC PSYCHOLOG
Other - Prefix:MRS
Other - First Name:ZELJKA
Other - Middle Name:
Other - Last Name:ROKSANDIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TEACHER, ENTREPRENEU
Mailing Address - Street 1:110 LA GRANGE ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-1718
Mailing Address - Country:US
Mailing Address - Phone:607-724-2438
Mailing Address - Fax:
Practice Address - Street 1:110 LA GRANGE ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-1718
Practice Address - Country:US
Practice Address - Phone:607-724-2438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-22
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care