Individual provider · Type 1 NPI
Jeanette M. Gerould, PA
Surgical Physician Assistant · Cliffside Park, NJ
NPI number
1700139540
Active
Practice location
663 Palisade Ave
Cliffside Park, NJ 07010-3012
Fax (201) 943-7308
Mailing address
111 Galway Pl
Teaneck, NJ 07666-3640
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 25MP00293700 (NJ) |
Surgical Physician Assistant: Definition to come...
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Other surgical physician assistant providers in Cliffside Park
About NPI 1700139540
Jeanette M. Gerould, PA's National Provider Identifier is 1700139540, issued on Oct 17, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Cliffside Park, NJ. The record was last updated on Oct 17, 2012.