Provider Demographics
NPI:1750346409
Name:GERSTENBLITH, JAY (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:
Last Name:GERSTENBLITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3455 WILKENS AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5213
Mailing Address - Country:US
Mailing Address - Phone:410-644-5114
Mailing Address - Fax:410-644-0166
Practice Address - Street 1:3455 WILKENS AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5213
Practice Address - Country:US
Practice Address - Phone:410-644-5114
Practice Address - Fax:410-644-0166
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0020724207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease