Provider Demographics
NPI:1700833399
Name:GERSON ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:GERSON ASSOCIATES, P.C.
Other - Org Name:UNIVERSITY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-637-6800
Mailing Address - Street 1:2837 SOUTHAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-1206
Mailing Address - Country:US
Mailing Address - Phone:215-637-6800
Mailing Address - Fax:215-637-7967
Practice Address - Street 1:10551 DECATUR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-3800
Practice Address - Country:US
Practice Address - Phone:215-637-6800
Practice Address - Fax:215-637-7967
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GERSON ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-28
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016803E2084N0400X
261QS1200X
PA6000006361332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100735713Medicaid
PA50591300004Medicare ID - Type Unspecified
PA100735713Medicaid