Healthcare Provider Details

I. General information

NPI: 1760015903
Provider Name (Legal Business Name): GEETA K VERMA DNP, FNP-BC, WCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 BROADWAY
AMITYVILLE NY
11701-2719
US

IV. Provider business mailing address

1410 NORTHERN BLVD # 1141
MANHASSET NY
11030-3051
US

V. Phone/Fax

Practice location:
  • Phone: 631-789-2020
  • Fax:
Mailing address:
  • Phone: 516-244-4033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number345523
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: