Individual
DR. RICHARD T. GERVASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 CROSS ST, 4TH FL, NORWALK, CT 06851-4647
(203) 845-4800
(203) 845-4873
Mailing address
2700 WESTCHESTER AVE, PURCHASE, NY 10577-2547
(914) 607-5730
(914) 457-1195
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042201
CT
207RN0300X
Nephrology Physician
Primary
042201
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972597813
—
CT
Enumeration date
09/07/2005
Last updated
03/26/2018
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