Provider Demographics
NPI:1972561884
Name:GERBARG, PATRICIA L (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:GERBARG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 SHERRY LN
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4724
Mailing Address - Country:US
Mailing Address - Phone:914-715-1580
Mailing Address - Fax:845-331-3562
Practice Address - Street 1:86 SHERRY LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4724
Practice Address - Country:US
Practice Address - Phone:914-715-1580
Practice Address - Fax:845-331-3562
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1526672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY90A271Medicare PIN
A68140Medicare UPIN