Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1378 | TX |
N | 222Z00000X | Podiatrist | 1378 | TX |
Y | 213EP1101X | Primary Podiatric Medicine | 307 | NM |
NPI | 1235181199 |
---|---|
Provider Name | Dr. Gloria Isabel Gerstner |
First Address | Albuquerque, NM 87109-4474 |
Second Address | Albuquerque, NM 87109-4474 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 06/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10007865 | (05) | NM |
11647136 | CAQH (01) | NM |
215K7GE | BC BS (01) | |
2700428 | MEDICA (01) | |
585241041567 | PREFERRED ONE (01) | |
NM00086 | MEDICARE PTAN INDIVIDUAL (01) | NM |
NM009A43 | BCBS (01) | NM |
NM400263 | MEDICARE PTAN INDIVIDUAL (01) | NM |
U71889 | (02) |