Provider Demographics
NPI:1932719671
Name:BOY, GERALD KRISTOFFER ESCARECES (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD KRISTOFFER
Middle Name:ESCARECES
Last Name:BOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 E 46TH ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-2944
Mailing Address - Country:US
Mailing Address - Phone:914-582-0435
Mailing Address - Fax:
Practice Address - Street 1:2100 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2818
Practice Address - Country:US
Practice Address - Phone:914-582-0435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2023-08-30
Deactivation Date:2021-10-20
Deactivation Code:
Reactivation Date:2023-06-13
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC202302200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program