Provider Demographics
NPI:1902894009
Name:FLORIO, GERARD ANDREW (PHD)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:ANDREW
Last Name:FLORIO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PARK ST
Mailing Address - Street 2:GLENS FALLS HOSPITAL
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4413
Mailing Address - Country:US
Mailing Address - Phone:518-926-6620
Mailing Address - Fax:518-926-1954
Practice Address - Street 1:102 PARK ST
Practice Address - Street 2:CR WOOD CANCER CENTER
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4403
Practice Address - Country:US
Practice Address - Phone:518-926-6620
Practice Address - Fax:518-926-1954
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013594103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00092394OtherRR MEDICARE
NYCC7000Medicare PIN
NYP00092394OtherRR MEDICARE