Healthcare Provider Details

I. General information

NPI: 1013221050
Provider Name (Legal Business Name): GERALYN M GEDAKA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

994 W SHERMAN AVE BLDG 2
VINELAND NJ
08360-6937
US

IV. Provider business mailing address

994 W SHERMAN AVE BLDG 2
VINELAND NJ
08360-6937
US

V. Phone/Fax

Practice location:
  • Phone: 609-383-0200
  • Fax: 631-534-7246
Mailing address:
  • Phone: 631-534-7246
  • Fax: 856-457-5681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00294700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: