Provider Demographics
NPI:1942325774
Name:JOSEPH GERARDI, MD, PC
Entity Type:Organization
Organization Name:JOSEPH GERARDI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GERARDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-393-2070
Mailing Address - Street 1:1532 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6002
Mailing Address - Country:US
Mailing Address - Phone:518-393-2070
Mailing Address - Fax:518-383-4223
Practice Address - Street 1:1532 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-6002
Practice Address - Country:US
Practice Address - Phone:518-393-2070
Practice Address - Fax:518-383-4223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0457Medicare ID - Type UnspecifiedGRP #