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General NPI Number Information
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NPI Number | 1487688214
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Entity Type | Individual
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Provider Name | GREGORY GERSTEN MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 385 MAIN ST S UNION SQUARE
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City | SOUTHBURY
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State | CT
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Zip | 06488-4240
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Country | US
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Telephone | 203-264-7999
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Fax | 203-264-7477
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Provider Business Mailing Address
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Address Line | 385 MAIN ST S UNION SQUARE BLDG #1 C O NVRA IMAGING NETWORK
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City | SOUTHBURY
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State | CT
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Zip | 06488-4240
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Country | US
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Telephone | 203-264-7999
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Fax | 203-264-7477
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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 | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 036955
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 036955
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036955
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License Number State | CT
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