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General NPI Number Information
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NPI Number | 1518937234
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Entity Type | Individual
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Provider Name | GARY BRIAN KERSHNER DO
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 1050 GALLOPING HILL ROAD SUITE 202
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City | UNION
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State | NJ
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Zip | 07083
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Country | US
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Telephone | 908-688-4845
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Fax | 908-687-2039
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Provider Business Mailing Address
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Address Line | PO BOX 416457
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City | BOSTON
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State | MA
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Zip | 02241-6457
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Country | US
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Telephone | 973-656-6280
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Fax | 973-290-7495
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB07312400
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License Number State | NJ
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