Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 023989 | NY |
NPI | 1902803794 |
---|---|
Provider Name | Dr. Carl Gerard |
First Address | Rochester, NY 14626-2724 |
Second Address | Rochester, NY 14626-2724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 08/07/2007 |