Active NPI
Ira Harvey Gerson, L.C.S.W.
- Clinical Social Worker
- New York, NY
National Provider Identifier
1164575510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R016541-1
- Practice address
- 1901 1St Ave
4M17
New York, NY 10029-7404 - Phone
- (212) 423-8259
- Fax
- (212) 423-6388
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R016541-1 | NY | Primary |
Addresses
Primary practice location
1901 1St Ave
4M17
New York, NY 10029-7404
Mailing address
473 FDR Dr
K604
New York, NY 10002-2024
Phone (212) 533-4988
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 979476 | Other | NY | PROVIDER NUMBER |
| R016541-1 | Other | NY | N.Y.S LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R016541-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164575510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "473 FDR DR",
"address_2": "K604",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100022024",
"telephone_number": "212-533-4988",
"fax_number": "212-423-6534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 1ST AVE",
"address_2": "4M17",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100297404",
"telephone_number": "212-423-8259",
"fax_number": "212-423-6388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERSON",
"first_name": "IRA",
"middle_name": "HARVEY",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R016541-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "979476",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N.Y.S LICENSE NUMBER",
"identifier": "R016541-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.