Individual
MAXIM LUCAS GERSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4383
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
77109
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2020
Last updated
11/20/2024
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