Healthcare Provider Details

I. General information

NPI: 1326098559
Provider Name (Legal Business Name): RAMI E GEFFNER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W WATER ST
TOMS RIVER NJ
08753-6407
US

IV. Provider business mailing address

PO BOX 4979
TOMS RIVER NJ
08754-4979
US

V. Phone/Fax

Practice location:
  • Phone: 732-244-4700
  • Fax: 732-244-2804
Mailing address:
  • Phone: 732-244-4703
  • Fax: 732-244-2804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA06782900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA03772900
License Number StateNJ

VIII. Authorized Official

Name: MR. RAMI E GEFFNER
Title or Position: OWNER
Credential: MD
Phone: 732-244-4703