Provider Demographics
NPI:1912935479
Name:GENTCHOS, ERNEST J (MD)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:J
Last Name:GENTCHOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3737 MARKET ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5545
Mailing Address - Country:US
Mailing Address - Phone:215-662-3340
Mailing Address - Fax:215-222-8875
Practice Address - Street 1:3737 MARKET ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5545
Practice Address - Country:US
Practice Address - Phone:215-662-3340
Practice Address - Fax:215-222-8875
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD038220E207X00000X
NJ25MA02002200207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001681098Medicaid
PA001681098Medicaid
C60246Medicare UPIN
PA005162Medicare PIN