Provider Demographics
NPI:1760135347
Name:GERHARDT, CRAIG (OTR)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:GERHARDT
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-9391
Mailing Address - Country:US
Mailing Address - Phone:315-759-1641
Mailing Address - Fax:
Practice Address - Street 1:1 KEUKA BUSINESS PARK
Practice Address - Street 2:SUITE 118
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527
Practice Address - Country:US
Practice Address - Phone:315-694-9056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation