Basic Information
| Provider Information | |||||||||
| NPI: | 1013929132 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GERSAPPE | ||||||||
| FirstName: | ANAND | ||||||||
| MiddleName: | ASHOK | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 25608 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841250608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063204476 | ||||||||
| FaxNumber: | 2065687043 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 17TH AVE | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981225788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063864744 | ||||||||
| FaxNumber: | 2062151135 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 03/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | MD60142525 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 2084S0012X | 229751 | NY | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine | 2084S0012X | MD60142525 | WA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000528226003 | 01 | NY | BCBS OF WNY | OTHER | 000528226001 | 01 | NY | BCBS OF WNY | OTHER | 000528226002 | 01 | NY | BCBS OF WNY | OTHER | 000528226004 | 01 | NY | BCBS OF WNY | OTHER | 00027478301 | 01 | NY | UNIVERA HEALTHCARE | OTHER | 161598214 | 01 | NY | TAX IDENTIFICATION NUMBER | OTHER | 0512877 | 01 | NY | INDEPENDENT HEALTH | OTHER |