Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Adam Gerasimovich

Individual provider Physician Assistant · NPI 1013654854

Kenneth Adam Gerasimovich is a Physician Assistant in Glen Head, New York. Works from 2 locations. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2

Practice location Address checks out

11 Willow Pl
Glen Head, NY 11545-1561
Phone: (516) 528-0194
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Healthy Way, Oceanside, NY 11572-1551 — (516) 632-3000

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1013654854
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 13, 2022
Last updated in NPPESJanuary 10, 2023
Certification dateJanuary 10, 2023

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