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General NPI Number Information
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NPI Number | 1205347994
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Entity Type | Individual
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Provider Name | ALINA GERASYMOVA PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 15245 SHADY GROVE RD STE 370
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City | ROCKVILLE
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State | MD
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Zip | 20850-6237
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Country | US
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Telephone | 240-246-7417
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Fax | 240-477-4364
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Provider Business Mailing Address
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Address Line | 15245 SHADY GROVE RD STE 370
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City | ROCKVILLE
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State | MD
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Zip | 20850-6237
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Country | US
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Telephone | 240-246-7417
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Fax | 240-477-4364
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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 | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | C0006647
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C06647
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License Number State | MD
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