Gerasimovich, Kenneth Adam

Gerasimovich, Kenneth Adam is an individual health care provider with primary practice located at 11 Willow Pl , Glen Head NY 11545-1561. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is his primary health care specialty. Gerasimovich, Kenneth Adam can be contacted via phone (516) 528-0194.

Contact Information

Primary practice address
11 Willow Pl Glen Head NY 11545-1561
Phone: (516) 528-0194
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1013654854
LBN Legal business name Gerasimovich, Kenneth Adam
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2022
Last updated Jan 10th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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