MEDICARE: DR. PAUL ALLEN GELLER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	037417	NY

General Provider Information

NPI Number	:	1578566220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL ALLEN GELLER D.D.S.

Provider Business Mailing Address
First Line	:	280 MAMARONECK AVE
Second Line	:	STE 307
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-1460
Country	:	US
Telephone Number	:	914-949-8266
Fax Number	:	914-949-9878

Provider Business Practice Location Address
First Line	:	280 MAMARONECK AVE
Second Line	:	STE 307
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-1460
Country	:	US
Telephone Number	:	914-949-8266
Fax Number	:	914-949-9878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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