Provider Demographics
NPI:1285790865
Name:JOSEPH A. GERSHEY, D.P.M., P.C.
Entity type:Organization
Organization Name:JOSEPH A. GERSHEY, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:GERSHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:570-489-8866
Mailing Address - Street 1:1034 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18519-1340
Mailing Address - Country:US
Mailing Address - Phone:570-489-8866
Mailing Address - Fax:570-489-8875
Practice Address - Street 1:1034 MAIN ST
Practice Address - Street 2:
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1340
Practice Address - Country:US
Practice Address - Phone:570-489-8866
Practice Address - Fax:570-489-8875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003369L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101504256001Medicaid
PA089325Medicare PIN
PAU17082Medicare UPIN