Provider Demographics
NPI:1962598045
Name:GELDER MEDICAL PLLC
Entity type:Organization
Organization Name:GELDER MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-563-9901
Mailing Address - Street 1:44 PEARL STREET
Mailing Address - Street 2:GELDER MEDICAL GROUP
Mailing Address - City:SIDNEY
Mailing Address - State:NY
Mailing Address - Zip Code:13838
Mailing Address - Country:US
Mailing Address - Phone:607-563-9961
Mailing Address - Fax:607-563-8804
Practice Address - Street 1:44 PEARL STREET
Practice Address - Street 2:GELDER MEDICAL GROUP
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838
Practice Address - Country:US
Practice Address - Phone:607-563-9961
Practice Address - Fax:607-563-8804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00514003Medicaid
NYB80294Medicare UPIN
NYAA0053Medicare PIN