Provider Demographics
NPI:1811194137
Name:DR. GERALD A. ESMOND, DPM,PC
Entity Type:Organization
Organization Name:DR. GERALD A. ESMOND, DPM,PC
Other - Org Name:EAST END ENDOCRINE & ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ESMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-350-5400
Mailing Address - Street 1:34 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3907
Mailing Address - Country:US
Mailing Address - Phone:516-350-5400
Mailing Address - Fax:
Practice Address - Street 1:189 MAIN RD
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-1957
Practice Address - Country:US
Practice Address - Phone:516-350-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005582213ES0131X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100016392Medicare PIN
NYU84837Medicare UPIN