Provider Demographics
NPI:1942188537
Name:GERGES, MINA (PT)
Entity type:Individual
Prefix:
First Name:MINA
Middle Name:
Last Name:GERGES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5517 ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-3316
Mailing Address - Country:US
Mailing Address - Phone:347-417-6451
Mailing Address - Fax:
Practice Address - Street 1:7119 80TH ST STE 80210
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7738
Practice Address - Country:US
Practice Address - Phone:718-554-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist