Provider Demographics
NPI:1124136569
Name:CHISNALL, GERARD GEORGE (RPA)
Entity type:Individual
Prefix:MR
First Name:GERARD
Middle Name:GEORGE
Last Name:CHISNALL
Suffix:
Gender:M
Credentials:RPA
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Mailing Address - Street 1:4864 CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8116
Mailing Address - Country:US
Mailing Address - Phone:610-751-8817
Mailing Address - Fax:
Practice Address - Street 1:151 KNOLLCROFT RD
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:NJ
Practice Address - Zip Code:07939-5001
Practice Address - Country:US
Practice Address - Phone:908-647-0180
Practice Address - Fax:908-604-5850
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY23-00763363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant