Provider Demographics
NPI:1174687628
Name:GERSON, RACHEL FAYE (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:FAYE
Last Name:GERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:491 ALLENDALE RD
Mailing Address - Street 2:STE 104
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1430
Mailing Address - Country:US
Mailing Address - Phone:215-860-3360
Mailing Address - Fax:215-860-3362
Practice Address - Street 1:777 TOWNSHIP LINE ROAD
Practice Address - Street 2:SUITE 150
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5567
Practice Address - Country:US
Practice Address - Phone:215-860-3360
Practice Address - Fax:215-860-3362
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA122046002085R0202X
PAMD4831472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8475824Medicaid
WA8865022Medicare Oscar/Certification
WA8475824Medicaid
WAP00649500Medicare PIN
WAG8875354Medicare PIN
WAG8875370Medicare PIN
WAP00649502Medicare PIN