Provider Demographics
NPI:1255055034
Name:J GERSCH PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:J GERSCH PHYSICAL THERAPY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GERSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-527-9158
Mailing Address - Street 1:1508 ROUTE 9W STE 1
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-5436
Mailing Address - Country:US
Mailing Address - Phone:845-691-9169
Mailing Address - Fax:845-691-3864
Practice Address - Street 1:1508 ROUTE 9W STE 1
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NY
Practice Address - Zip Code:12542-5436
Practice Address - Country:US
Practice Address - Phone:845-691-9169
Practice Address - Fax:845-691-3864
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J GERSCH PHYSICAL THERAPY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-27
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center