Provider Demographics
NPI:1831199165
Name:CASALE, GERARD M (MD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:M
Last Name:CASALE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:439 PORT RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-1714
Mailing Address - Country:US
Mailing Address - Phone:718-924-2254
Mailing Address - Fax:718-442-0189
Practice Address - Street 1:235 PORT RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-1701
Practice Address - Country:US
Practice Address - Phone:718-876-1732
Practice Address - Fax:718-815-3462
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2021-02-26
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Provider Licenses
StateLicense IDTaxonomies
NY159972207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY87D111Medicare ID - Type Unspecified