Basic Information
| Provider Information | |||||||||
| NPI: | 1700521192 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERLACH | ||||||||
| FirstName: | DAWID | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 NIMITZ PL | ||||||||
| Address2: | |||||||||
| City: | SAYREVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088721055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324391278 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 MELLON WAY | ||||||||
| Address2: | |||||||||
| City: | LATROBE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156501197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245371485 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2022 | ||||||||
| LastUpdateDate: | 05/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OT021459 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.