Provider Demographics
NPI:1063728269
Name:GERSTNER, JASON DANIEL (PHARMD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:DANIEL
Last Name:GERSTNER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 MILL ST
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:504-296-5806
Mailing Address - Fax:
Practice Address - Street 1:1155 MILL ST
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1576
Practice Address - Country:US
Practice Address - Phone:504-296-5806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist