Doctor Name: | JAMES GERSON |
NPI Number: | 1336406040 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MEDICAL STUDENT |
License Number: | |
Business Practice Address: | 37995 Fairmount Blvd Chagrin Falls, OH - 440226617 |
Business Phone Number: | 4407961513 |
Business Fax Number: | |
Mailing Address: | 119 N 20th St, Apt 1 PHILADELPHIA |
State: | PA |
Postal Code: | 191031452 |
Phone Number: | 4407961513 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2012 |
NPI Last Update Date: | 06/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |