Thomas R Gerbasi, M.D.
Individual provider Active NPI Pediatrics Physician · Lewiston, NY
NPI 1457324014 · NPPES record last updated Aug 5, 2016
Key facts
- NPI
- 1457324014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 131077 (NY)
- Practice address
- 733 Center Street
Lewiston, NY 14092 - Phone
- (716) 754-7337
- Fax
- (716) 754-2041
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131077 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lewiston Village Pediatrics | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 131077 | NY | Yes |
Addresses
Primary practice location
733 Center Street
Lewiston, NY 14092
Mailing address
733 Center Street
Lewiston, NY 14092
Phone (716) 754-7337
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00586883 | Medicaid | NY |
Other providers in Lewiston, NY
- Jillian Frandina
- John Leonard Frandina
- Elizabeth Galland
- Lewis Charles Garlow
- Gerald Pucillo Applied Behavior Analyst, P.C.
- Kimberly Moniwue Gilmore Jackson
- Gina Godwin
- Craig Gonzales Sr.
- William T Goode I
- Nakeata Graham
All providers in Lewiston, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.