MEDICARE: DR. YOUSTINA M GERGES DPT

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	225100000X	Physical Therapist	40QA01946500	NJ

General Provider Information

NPI Number	:	1528672557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOUSTINA M GERGES DPT

Provider Business Mailing Address
First Line	:	511 GOFFLE RD # 203
Second Line	:
City	:	WYCKOFF
State	:	NJ
Zip	:	07481-2926
Country	:	US
Telephone Number	:	201-899-1166
Fax Number	:

Provider Business Practice Location Address
First Line	:	511 GOFFLE RD # 203
Second Line	:
City	:	WYCKOFF
State	:	NJ
Zip	:	07481-2926
Country	:	US
Telephone Number	:	201-899-1166
Fax Number	:

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

Provider Enumeration Date	:	09/08/2020
Last Update Date	:	06/10/2026

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