Provider Demographics
NPI:1982824488
Name:GERSTEIN, BRAD JEFFREY (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:JEFFREY
Last Name:GERSTEIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ATHERTON AVE
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:PA
Mailing Address - Zip Code:18644-1814
Mailing Address - Country:US
Mailing Address - Phone:570-693-4752
Mailing Address - Fax:
Practice Address - Street 1:BOSSARDVILL RD AND BUSINESS
Practice Address - Street 2:RTE 209
Practice Address - City:SCIOTA
Practice Address - State:PA
Practice Address - Zip Code:18354
Practice Address - Country:US
Practice Address - Phone:570-992-6300
Practice Address - Fax:570-402-2900
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004030L111N00000X
PARP046250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered183500000XPharmacy Service ProvidersPharmacist