Provider Demographics
NPI:1972551117
Name:GERSON, ANDREW GERALD (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:GERALD
Last Name:GERSON
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:PO BOX 22581
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:610-482-4795
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:353 MEDICAL OFFICE BUILDING EAST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-649-9021
Practice Address - Fax:610-649-8058
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0002748207VM0101X
PAMD025391E207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00089479Medicaid
PA2330386000OtherBC/BS KEY, PER. GROUP
PA30018989OtherKEYSTONE MERCY GROUP
PA33659OtherHEALTH PARTNERS
PA3716959OtherAETNA US HEALTHCARE GROUP
PA4092784OtherAETNA US HEALTHCARE
PA0089479012OtherAMERICHOICE
PA119891OtherBC/BS HIGHMARK GROUP
PA3716980OtherAETNA US HEALTHCARE HMO
PA0081118000OtherBC/BS KEYSTONE, PERSONAL
PA30018992OtherKEYSTONE MERCY
PA02640OtherHEALTH PARTNERS
PA1652891OtherBC/BS HIGHMARK GROUP
PA33657OtherHEALTH PARTNERS
PA33658OtherHEALTH PARTNERS
PA30018992OtherKEYSTONE MERCY
119891TGWMedicare ID - Type Unspecified