Provider Demographics
NPI:1881767002
Name:PAMELA V GEKAS DPM
Entity type:Organization
Organization Name:PAMELA V GEKAS DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:VAIA
Authorized Official - Last Name:GEKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-582-3550
Mailing Address - Street 1:707 NORTH MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028
Mailing Address - Country:US
Mailing Address - Phone:856-582-3550
Mailing Address - Fax:856-582-3737
Practice Address - Street 1:707 NORTH MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028
Practice Address - Country:US
Practice Address - Phone:856-582-3550
Practice Address - Fax:856-582-3737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00188200213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4662008Medicaid
NJ463507Medicare PIN
NJ0688120001Medicare NSC
NJ4662008Medicaid