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General NPI Number Information
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NPI Number | 1053098319
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Entity Type | Individual
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Provider Name | SCOTT M GERSON
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Gender | Male
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 160 W 26TH ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10001-6975
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Country | US
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Telephone | 212-812-3692
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Fax |
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Provider Business Mailing Address
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Address Line | 878 GREENE AVE APT 3L
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City | BROOKLYN
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State | NY
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Zip | 11221-2329
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Country | US
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Telephone | 240-472-6889
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P122505
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License Number State | NY
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