Basic Information
| Provider Information | |||||||||
| NPI: | 1437142445 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERIKE | ||||||||
| FirstName: | ALBINA | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13621 NW 12TH ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | SUNRISE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333232808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002433839 | ||||||||
| FaxNumber: | 8444148291 | ||||||||
| Practice Location | |||||||||
| Address1: | 175 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNT HOLLY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080602038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563253952 | ||||||||
| FaxNumber: | 8558514405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2005 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 26NJ00259800 | NJ | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | N096564 | NJ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 1386654036 | 01 | NJ | AMERICAN ANESTHESIOLOGY OF NEW JERSEY, PC | OTHER |