Provider Demographics
NPI:1669519690
Name:GERSON, SCOTT (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:GERSON
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:SCOTT
Other - Middle Name:
Other - Last Name:GERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:584 MILLTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-5224
Mailing Address - Country:US
Mailing Address - Phone:845-278-8700
Mailing Address - Fax:845-278-8215
Practice Address - Street 1:584 MILLTOWN ROAD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-5224
Practice Address - Country:US
Practice Address - Phone:845-278-8700
Practice Address - Fax:845-278-8215
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine