Healthcare Provider Details
I. General information
NPI: 1083659064
Provider Name (Legal Business Name): DEBORA K GELLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/17/2006
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
466 OLD HOOK RD
EMERSON NJ
07630-1396
US
IV. Provider business mailing address
271 GROVE AVE STE E
VERONA NJ
07044-1730
US
V. Phone/Fax
- Phone: 201-649-8100
- Fax: 833-483-1609
- Phone: 973-559-3700
- Fax: 833-484-1686
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 25MA07940500 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: