Healthcare Provider Details

I. General information

NPI: 1760386387
Provider Name (Legal Business Name): DR. SANTINA ROSE GERSTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W MAIN ST
MARION IL
62959-1188
US

IV. Provider business mailing address

148 KNAPPS KNOLLE RD
UTICA NY
13502-7711
US

V. Phone/Fax

Practice location:
  • Phone: 618-997-5311
  • Fax:
Mailing address:
  • Phone: 315-525-0251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number003423
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: