Individual
JEANETTE M GEROULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
663 PALISADE AVE, CLIFFSIDE PARK, NJ 07010-3012
(201) 943-9100
(201) 943-7308
Mailing address
111 GALWAY PL, TEANECK, NJ 07666-3640
(201) 833-9500
(201) 862-0095
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00293700
NJ
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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