| Larisa Gershman Medical Center Pc | |
|
191 Hamburg Tpke Ste 2b Pompton Lakes NJ 07442-2332 | |
| (973) 248-9446 | |
| (973) 248-9445 |
| Full Name | Larisa Gershman Medical Center Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 191 Hamburg Tpke Ste 2b, Pompton Lakes, New Jersey |
| Authorized Official Name and Position | Larisa K Gershman (PRESIDENT) |
| Authorized Official Contact | 9732489446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larisa Gershman Medical Center Pc 191 Hamburg Tpke Ste 2b Pompton Lakes NJ 07442-2332 Ph: (973) 248-9446 | Larisa Gershman Medical Center Pc 191 Hamburg Tpke Ste 2b Pompton Lakes NJ 07442-2332 Ph: (973) 248-9446 |
| NPI Number | 1174715817 |
|---|---|
| Provider Enumeration Date | 08/16/2007 |
| Last Update Date | 10/24/2007 |
| Medicare PECOS PAC ID | 6901842285 |
|---|---|
| Medicare Enrollment ID | O20050708000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174715817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA07011700 (New Jersey) | Primary |
| Provider Name | Larisa K Gershman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447223201 PECOS PAC ID: 7618925926 Enrollment ID: I20050104000238 |
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