Healthcare Provider Details

I. General information

NPI: 1346041548
Provider Name (Legal Business Name): GEFFRARDS ENTREPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 HAMILTON AVE
BRENTWOOD NY
11717-3635
US

IV. Provider business mailing address

15 HAMILTON AVE
BRENTWOOD NY
11717-3635
US

V. Phone/Fax

Practice location:
  • Phone: 347-922-6918
  • Fax:
Mailing address:
  • Phone: 347-922-6918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: TANIA JEAN-GEFFRARD
Title or Position: MANAGER
Credential: MPH
Phone: 347-922-6918