MEDICARE: MICHELLE GEROVICH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	XXXXXX	NY

General Provider Information

NPI Number	:	1982562195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE GEROVICH

Provider Business Mailing Address
First Line	:	1733 SHEEPSHEAD BAY RD STE 12
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3728
Country	:	US
Telephone Number	:	718-975-7730
Fax Number	:	718-975-7728

Provider Business Practice Location Address
First Line	:	1733 SHEEPSHEAD BAY RD STE 12
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3728
Country	:	US
Telephone Number	:	718-975-7730
Fax Number	:	718-975-7728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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