Provider Demographics
NPI:1811971047
Name:HERRINE, GAIL MARGARET (MD)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:MARGARET
Last Name:HERRINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E ALLEGHENY AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4427
Mailing Address - Country:US
Mailing Address - Phone:215-926-3700
Mailing Address - Fax:215-926-3702
Practice Address - Street 1:2301 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4427
Practice Address - Country:US
Practice Address - Phone:215-707-3008
Practice Address - Fax:215-707-1387
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042440E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA160057394OtherRR MEDICARE
PA11314OtherBRAVO HEALTH
PA3Y7763OtherHEALTH NET
PA003293301OtherAMERICHOICE
PA3690011OtherAETNA HMO
PA001147900Medicaid
PA30022432OtherKMHP
PA519059OtherCOVENTRY HEALTH AMERICA
PA1616695OtherHIGHMARK BLUE SHIELD
PA2294726000OtherINDEPENDENCE BLUE CROSS
PAP00721316OtherRR MEDICARE INDIVIDUAL
PA519059OtherCOVENTRY HEALTH AMERICA
PA3690011OtherAETNA HMO
PA001147900Medicaid