Provider Demographics
NPI:1710982749
Name:PEER, GERALD L (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:L
Last Name:PEER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 EGGERT RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4156
Mailing Address - Country:US
Mailing Address - Phone:716-838-0640
Mailing Address - Fax:716-838-0787
Practice Address - Street 1:1230 EGGERT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4156
Practice Address - Country:US
Practice Address - Phone:716-838-0640
Practice Address - Fax:716-838-0787
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154046208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00914241Medicaid
NYBB8653Medicare ID - Type Unspecified
NY00914241Medicaid