Provider Demographics
NPI:1912383852
Name:GEREZ, TOBY GREGORI
Entity Type:Individual
Prefix:
First Name:TOBY
Middle Name:GREGORI
Last Name:GEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44481-1206
Mailing Address - Country:US
Mailing Address - Phone:330-399-2221
Mailing Address - Fax:330-394-0122
Practice Address - Street 1:320 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44481-1206
Practice Address - Country:US
Practice Address - Phone:330-399-2221
Practice Address - Fax:330-394-0122
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT015535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist