Individual
BRIAN GERLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
Mailing address
76 ROXBURY DR, COMMACK, NY 11725-1343
(631) 960-2516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
23020327
NY
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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