Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | LP02621 | RI |
NPI | 1003177064 |
---|---|
Provider Name | Colleen Gerrity |
First Address | Yonkers, NY 10710-2020 |
Second Address | Bronx, NY 10457-1526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2012 |
Last Update Date | 04/06/2015 |