Kenneth Adam Gerasimovich

NPI #1013654854 in Glen Head, New York

Provider Information

NPI Number: 1013654854
Entity Type: Individual
Name: Kenneth Adam Gerasimovich
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: May 13, 2022
Last Updated: Jan 10, 2023

Practice Location

Address: 11 WILLOW PL
City: Glen Head
State: New York
ZIP Code: 11545-1561
Phone: (516) 528-0194

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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