Healthcare Provider Details

I. General information

NPI: 1366491110
Provider Name (Legal Business Name): RAMI E GEFFNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 06/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 HIGHWAY 35 N
NEPTUNE NJ
07753-4743
US

IV. Provider business mailing address

1580 LAKEWOOD RD SUITE 16
TOMS RIVER NJ
08755-3287
US

V. Phone/Fax

Practice location:
  • Phone: 732-456-7777
  • Fax: 848-251-2189
Mailing address:
  • Phone: 732-456-7777
  • Fax: 848-251-2189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number25MA03772900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA03772900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: