Provider Demographics
NPI:1942247994
Name:GERSH, RICHARD JAY (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAY
Last Name:GERSH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:119 W 57TH ST
Mailing Address - Street 2:SUITE 620
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2303
Mailing Address - Country:US
Mailing Address - Phone:917-484-6406
Mailing Address - Fax:212-423-6534
Practice Address - Street 1:119 W 57TH ST
Practice Address - Street 2:SUITE 620
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2303
Practice Address - Country:US
Practice Address - Phone:917-484-6406
Practice Address - Fax:212-423-6534
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2013-09-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1644282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01207592Medicaid
NY164428OtherSTATE LICENSE
NYA60796Medicare UPIN
NY164428OtherSTATE LICENSE