Healthcare Provider Details

I. General information

NPI: 1780683300
Provider Name (Legal Business Name): SAMY B GERGIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 ROOSEVELT AVE
YORK PA
17404-2244
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-356-6250
  • Fax:
Mailing address:
  • Phone: 717-270-7780
  • Fax: 717-274-9746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD062186L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: