Healthcare Provider Details

I. General information

NPI: 1710940341
Provider Name (Legal Business Name): STEVEN EDWARD GELDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST
BELMONT MA
02478-1041
US

IV. Provider business mailing address

45 ALBAN RD
WABAN MA
02468-1934
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-2000
  • Fax: 617-855-3470
Mailing address:
  • Phone: 617-244-2202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number60151
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: