Provider Demographics
NPI:1427227909
Name:ROSALES, GERRY AGUINALDO JR (MD)
Entity type:Individual
Prefix:
First Name:GERRY
Middle Name:AGUINALDO
Last Name:ROSALES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 SOMERSET CIR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3495
Mailing Address - Country:US
Mailing Address - Phone:215-997-7359
Mailing Address - Fax:
Practice Address - Street 1:95 ALMSHOUSE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954
Practice Address - Country:US
Practice Address - Phone:215-357-5760
Practice Address - Fax:215-357-5731
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0008839207Q00000X
PAMD436075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE149981ZDESMedicare PIN