Provider Demographics
NPI:1881865137
Name:GERRITY, MAUREEN T (PA)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:T
Last Name:GERRITY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6075 BATHEY LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-7536
Mailing Address - Country:US
Mailing Address - Phone:239-455-8500
Mailing Address - Fax:239-455-6561
Practice Address - Street 1:6075 BATHEY LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7536
Practice Address - Country:US
Practice Address - Phone:239-455-8500
Practice Address - Fax:239-455-6561
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104138363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant