Provider Demographics
NPI:1639984040
Name:GEROSA, JAMES EDWARD (DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:GEROSA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14057 US HIGHWAY 17 STE 230
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3999
Mailing Address - Country:US
Mailing Address - Phone:910-821-3377
Mailing Address - Fax:
Practice Address - Street 1:14057 US HIGHWAY 17 STE 230
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-3999
Practice Address - Country:US
Practice Address - Phone:910-821-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23839225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist