# C CORINA GERONTIS MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366521445
- **Authorized official:** CATHERINE C GERONTIS MD (MD)
- **Authorized official phone:** (631) 439-5440

## Contact information

- **Practice address:** 353 VETERANS MEMORIAL HWY, SUITE 101, COMMACK, NY 11725-4233
- **Practice address phone:** (631) 439-5440
- **Practice address fax:** (631) 439-5447
- **Mailing address:** PO BOX 595, COMMACK, NY 11725-0595
- **Mailing address phone:** (631) 439-5440
- **Mailing address fax:** (631) 439-5447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | 188154 | NY | — |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 11/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01569231 | — | NY |