Provider Demographics
NPI:1609178235
Name:GERRA, LINDA LANTING (EDD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LANTING
Last Name:GERRA
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ROCKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1207
Mailing Address - Country:US
Mailing Address - Phone:914-699-2137
Mailing Address - Fax:
Practice Address - Street 1:9 ROCKRIDGE RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-1207
Practice Address - Country:US
Practice Address - Phone:914-699-2137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXXXXXXXXX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist