Provider Demographics
NPI:1841443223
Name:ZACHARY E. GERUT, M.D. F. A. C. S. P. C.
Entity type:Organization
Organization Name:ZACHARY E. GERUT, M.D. F. A. C. S. P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:GERUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-295-2100
Mailing Address - Street 1:1245 COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2006
Mailing Address - Country:US
Mailing Address - Phone:516-295-2100
Mailing Address - Fax:516-295-2487
Practice Address - Street 1:1245 COLONIAL RD
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2006
Practice Address - Country:US
Practice Address - Phone:516-295-2100
Practice Address - Fax:516-295-2487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64223Medicare UPIN