MEDICARE: GREGORY GERSTEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	036955	CT
2	2085B0100X	Body Imaging Physician	036955	CT
3	2085R0202X	Diagnostic Radiology Physician	036955	CT
4	2085R0202X	Diagnostic Radiology Physician	4271297	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487688214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY GERSTEN MD

Provider Business Mailing Address
First Line	:	385 MAIN ST S
Second Line	:	UNION SQUARE BLDG #1 C O NVRA IMAGING NETWORK
City	:	SOUTHBURY
State	:	CT
Zip	:	06488-4240
Country	:	US
Telephone Number	:	203-264-7999
Fax Number	:	203-264-7477

Provider Business Practice Location Address
First Line	:	385 MAIN ST S
Second Line	:	UNION SQUARE
City	:	SOUTHBURY
State	:	CT
Zip	:	06488-4240
Country	:	US
Telephone Number	:	203-264-7999
Fax Number	:	203-264-7477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	01/14/2026

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Directions to “ GREGORY GERSTEN MD” Practice Location

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