Provider Demographics
NPI:1184696734
Name:PERRY, GINA M (DO)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:M
Last Name:PERRY
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2295 N SUSQUEHANNA TRL
Mailing Address - Street 2:SUITE A
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-8495
Mailing Address - Country:US
Mailing Address - Phone:717-812-0731
Mailing Address - Fax:717-812-9848
Practice Address - Street 1:2295 N SUSQUEHANNA TRL
Practice Address - Street 2:SUITE A
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-8495
Practice Address - Country:US
Practice Address - Phone:717-812-0731
Practice Address - Fax:717-812-9848
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2011-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS010092L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA039846OtherGROUP PTAN
PA01807995Medicaid
PA039846OtherGROUP PTAN
PA040554N84Medicare ID - Type Unspecified