Individual
GERALD SURETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
Mailing address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
37FI00062300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0554338000
IBC
PA
01
—
7122088
AETNA
PA
Enumeration date
09/02/2006
Last updated
07/08/2007
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