Provider Demographics
NPI:1912090184
Name:GERRY HOMES INC
Entity type:Organization
Organization Name:GERRY HOMES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-338-9766
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:GERRY
Mailing Address - State:NY
Mailing Address - Zip Code:14740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3023 ROUTE 430
Practice Address - Street 2:
Practice Address - City:GREENHURST
Practice Address - State:NY
Practice Address - Zip Code:14742
Practice Address - Country:US
Practice Address - Phone:716-483-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00011450401OtherUNIVERA PROVIDER ID
NYY4OtherINDEPENDENT HEALTH
NY335721Medicare ID - Type Unspecified