Provider Demographics
NPI:1689680795
Name:GERSTMAN, ROBERT N (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:GERSTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:MC 13-35
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-9800
Mailing Address - Country:US
Mailing Address - Phone:570-271-6516
Mailing Address - Fax:570-271-5814
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:MC 13-35
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-271-6516
Practice Address - Fax:570-271-5814
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007772L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA228185000OtherMAGELLAN BEHAVIORAL HEALT
PA001529833Medicaid
PA228185000OtherMAGELLAN BEHAVIORAL HEALT
PA652231FJ1Medicare ID - Type Unspecified