Individual
MR. CHARLES P GERACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L-CSW
Contact information
Practice address
1050 HALLOCK AVE, SUITE 2, PORT JEFFERSON STATION, NY 11776-1214
(631) 930-6200
Mailing address
81 KATHERINE ST, PORT JEFFERSON STATION, NY 11776-1709
(631) 476-2104
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
073130-1
NY
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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