Provider Demographics
NPI:1750732814
Name:GERDA & ASSOCIATES, LLC
Entity type:Organization
Organization Name:GERDA & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GERDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTHERSIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-277-6195
Mailing Address - Street 1:12202 DALTON LN
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7026
Mailing Address - Country:US
Mailing Address - Phone:407-274-4029
Mailing Address - Fax:
Practice Address - Street 1:12202 DALTON LN
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-7026
Practice Address - Country:US
Practice Address - Phone:407-274-4029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty