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General NPI Number Information
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NPI Number | 1619814142
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Entity Type | Individual
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Provider Name | MARIA GERASIMOVA RN
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Gender | Female
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 400 RAMAPO AVE FL 2
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City | POMPTON LAKES
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State | NJ
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Zip | 07442-1825
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Country | US
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Telephone | 973-858-8163
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Fax | 862-666-1074
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Provider Business Mailing Address
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Address Line | 100 BAY LN
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City | WAYNE
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State | NJ
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Zip | 07470-2243
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Country | US
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Telephone | 973-699-2577
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 904278
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR15450900
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License Number State | NJ
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