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General NPI Number Information
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NPI Number | 1053542324
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Entity Type | Individual
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Provider Name | IGOR GERZON DDS
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Gender | Male
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 595 MADISON AVE SUITE 1208
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City | NEW YORK
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State | NY
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Zip | 10022
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Country | US
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Telephone | 212-339-8800
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Fax | 212-813-1953
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Provider Business Mailing Address
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Address Line | 595 MADISON AVENUE SUITE 1208
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City | NEW YORK
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State | NY
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Zip | 10022
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Country | US
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Telephone | 212-339-8800
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Fax | 212-813-1953
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 040866
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License Number State | NY
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