Basic Information
| Provider Information | |||||||||
| NPI: | 1700045382 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERDEMAN | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1367 WASHINGTON AVENEU | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122061048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184892666 | ||||||||
| FaxNumber: | 5184895933 | ||||||||
| Practice Location | |||||||||
| Address1: | 1367 WASHINGTON AVENEU | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122061048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184892666 | ||||||||
| FaxNumber: | 5184895933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2008 | ||||||||
| LastUpdateDate: | 03/24/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 242288 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.