Basic Information
| Provider Information | |||||||||
| NPI: | 1295128452 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ZACHARY E. GERUT, M.D. P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1245 COLONIAL RD | ||||||||
| Address2: | |||||||||
| City: | HEWLETT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115572006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162952100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1245 COLONIAL RD | ||||||||
| Address2: | |||||||||
| City: | HEWLETT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115572006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162952100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2015 | ||||||||
| LastUpdateDate: | 03/12/2015 | ||||||||
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| AuthorizedOfficialLastName: | GERUT | ||||||||
| AuthorizedOfficialFirstName: | ZACHARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5162952100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.