Healthcare Provider Details

I. General information

NPI: 1457857328
Provider Name (Legal Business Name): JENNIFER MICHELLE GELDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2018
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ALBAN RD
WABAN MA
02468-1934
US

IV. Provider business mailing address

45 ALBAN RD
WABAN MA
02468-1934
US

V. Phone/Fax

Practice location:
  • Phone: 617-302-6560
  • Fax: 580-297-9158
Mailing address:
  • Phone: 617-302-6560
  • Fax: 580-297-9158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number292302
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: