Provider Demographics
NPI:1710951637
Name:DESMOND, GERARD C (DPT)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:C
Last Name:DESMOND
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10166
Mailing Address - Country:US
Mailing Address - Phone:212-953-9494
Mailing Address - Fax:212-682-2013
Practice Address - Street 1:200 PARK AVENUE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10166
Practice Address - Country:US
Practice Address - Phone:212-953-9494
Practice Address - Fax:212-682-2013
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist