Provider Demographics
NPI:1598757627
Name:GERSTEIN, LAURIE POWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:POWELL
Last Name:GERSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 FERRY RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2391
Mailing Address - Country:US
Mailing Address - Phone:215-348-2992
Mailing Address - Fax:215-348-2052
Practice Address - Street 1:1456 FERRY RD
Practice Address - Street 2:SUITE 402
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2391
Practice Address - Country:US
Practice Address - Phone:215-348-2992
Practice Address - Fax:215-348-2052
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419046207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012425550001Medicaid
088557S4ZMedicare ID - Type Unspecified
I25931Medicare UPIN