Individual
TRACY GERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S PA-C
Contact information
Practice address
345 E 37TH ST RM 307, NEW YORK, NY 10016-3256
(212) 532-5355
Mailing address
315 W 57TH ST, SUITE 405, NEW YORK, NY 10019-3158
(561) 329-4666
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
017863-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017863
NY STATE
NY
Enumeration date
09/15/2014
Last updated
09/15/2015
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