Healthcare Provider Details

I. General information

NPI: 1679109656
Provider Name (Legal Business Name): CHLOE ELYSE GELESKY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 03/21/2020
Certification Date: 03/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MADISON AVE STE 110
MORRISTOWN NJ
07960-6083
US

IV. Provider business mailing address

20 AUBREY ST APT 2
SUMMIT NJ
07901-1409
US

V. Phone/Fax

Practice location:
  • Phone: 973-863-2360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number40QA01748800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: