Provider Demographics
NPI:1922260207
Name:GERARD J FURST DPM PLLC
Entity Type:Organization
Organization Name:GERARD J FURST DPM PLLC
Other - Org Name:GERARD J FURST DPM
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FURST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-331-8400
Mailing Address - Street 1:4 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-4047
Mailing Address - Country:US
Mailing Address - Phone:631-331-8400
Mailing Address - Fax:
Practice Address - Street 1:4 TECHNOLOGY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-4047
Practice Address - Country:US
Practice Address - Phone:631-331-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000234Medicare PIN