Provider Demographics
NPI:1013524370
Name:VILSAINT, GERARD DOMOND JR
Entity type:Individual
Prefix:
First Name:GERARD
Middle Name:DOMOND
Last Name:VILSAINT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-6425
Mailing Address - Country:US
Mailing Address - Phone:203-223-7749
Mailing Address - Fax:
Practice Address - Street 1:91 SOUTHWOOD DR
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-6425
Practice Address - Country:US
Practice Address - Phone:203-223-7749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)