Provider Demographics
NPI:1245324565
Name:GERARDI, EUGENE N (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:N
Last Name:GERARDI
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 1:1171 OLD COUNTRY RD
Mailing Address - Street 2:SUITE #5
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5022
Mailing Address - Country:US
Mailing Address - Phone:516-938-7676
Mailing Address - Fax:516-938-7718
Practice Address - Street 1:1171 OLD COUNTRY RD
Practice Address - Street 2:SUITE #5
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-5022
Practice Address - Country:US
Practice Address - Phone:516-938-7676
Practice Address - Fax:516-938-7718
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136160207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY74542OtherAETNA
NY66D483OtherBC/BS
NY2099867OtherGHI
NYP3604723OtherOXFORD
NY66D483OtherBC/BS
NYP3604723OtherOXFORD