Healthcare Provider Details

I. General information

NPI: 1649213422
Provider Name (Legal Business Name): STUART R GEFFNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 OLD SHORT HILLS RD EAST WING, SUITE 305
LIVINGSTON NJ
07039-5672
US

IV. Provider business mailing address

94 OLD SHORT HILLS RD EAST WING, SUITE 305
LIVINGSTON NJ
07039-5672
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-9801
  • Fax: 973-322-9807
Mailing address:
  • Phone: 973-322-9801
  • Fax: 973-322-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA05451600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: