Provider Demographics
NPI:1457386617
Name:GERSTMAN, IRA ZAMORE (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:ZAMORE
Last Name:GERSTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1244 FORT WASHINGTON AVE
Mailing Address - Street 2:SUITE N1
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034
Mailing Address - Country:US
Mailing Address - Phone:215-646-6504
Mailing Address - Fax:215-646-6546
Practice Address - Street 1:1244 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE N1
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034
Practice Address - Country:US
Practice Address - Phone:215-646-6504
Practice Address - Fax:215-646-6546
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-05-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA024724E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
416164FXQMedicare ID - Type Unspecified
B41435Medicare UPIN