Individual
DR. JOSEPH GERVASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
838 N BROADWAY UNIT B, MASSAPEQUA, NY 11758-2451
(516) 799-0550
(516) 799-0562
Mailing address
838 N BROADWAY UNIT B, MASSAPEQUA, NY 11758-2451
(516) 799-0550
(516) 799-0562
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
NOO3169-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00586434
—
NY
Enumeration date
10/01/2005
Last updated
05/26/2022
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