Provider Demographics
NPI:1952332199
Name:KERINS, GERARD JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:JOSEPH
Last Name:KERINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-789-3022
Mailing Address - Fax:203-789-3222
Practice Address - Street 1:1450 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-789-3022
Practice Address - Fax:203-789-3222
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030448207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP01130387OtherRAILROAD MEDICARE
CT1952332199OtherCONNECTICARE
CT1952332199OtherMULTIPLAN
CT1952332199OtherANTHEM
CT1952332199OtherTRICARE
CTP4569287OtherOXFORD
CT001304485Medicaid
CT121952332199OtherHEALTHY CT
CT1952332199OtherAETNA
CT1952332199OtherCIGNA
CT1952332199OtherUNITED HEALTHCARE
CT436637OtherWELLCARE
CT1952332199OtherTRICARE