Healthcare Provider Details

I. General information

NPI: 1124129390
Provider Name (Legal Business Name): JANNA GEFTER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2383 BELL BLVD
BAYSIDE NY
11360-2053
US

IV. Provider business mailing address

2350 WATERS EDGE DR 4D
BAYSIDE NY
11360-2232
US

V. Phone/Fax

Practice location:
  • Phone: 718-423-3535
  • Fax: 718-423-3581
Mailing address:
  • Phone: 718-645-2700
  • Fax: 718-645-3188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN006007-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: