Provider Demographics
NPI:1245322254
Name:GETS, GENNADIY (DPT)
Entity type:Individual
Prefix:
First Name:GENNADIY
Middle Name:
Last Name:GETS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:GENNADIY
Other - Middle Name:
Other - Last Name:GETS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:2182 WINHALL RD
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-0147
Mailing Address - Country:US
Mailing Address - Phone:718-406-5046
Mailing Address - Fax:
Practice Address - Street 1:2182 WINHALL RD
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-0147
Practice Address - Country:US
Practice Address - Phone:718-406-5046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023213-1225100000X
SC11084225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQP5561Medicare ID - Type Unspecified