Individual
GERALD J DURIVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
6 COLLIER DR, BLACKWOOD, NJ 08012-2983
(610) 908-9811
Mailing address
6 COLLIER DR, BLACKWOOD, NJ 08012-2983
(610) 908-9811
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP015225
PA
363LF0000X
Family Nurse Practitioner
Primary
SP015225
PA
Other
Enumeration date
09/14/2015
Last updated
12/09/2025
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