Provider Demographics
NPI:1982716668
Name:STONE, GERALD E (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:E
Last Name:STONE
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 1:155 CORPORATE WOODS
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1472
Mailing Address - Country:US
Mailing Address - Phone:585-784-7848
Mailing Address - Fax:585-784-7842
Practice Address - Street 1:155 CORPORATE WOODS
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1472
Practice Address - Country:US
Practice Address - Phone:585-784-7848
Practice Address - Fax:585-784-7842
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD78393Medicare UPIN
NYCC5163Medicare PIN
NYCC5165Medicare PIN