Healthcare Provider Details

I. General information

NPI: 1962446583
Provider Name (Legal Business Name): BARRY GELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HUDSON VALLEY HOSPITAL CENTER 1980 CROMPOND ROAD
CORTLANDT MANOR NY
10567
US

IV. Provider business mailing address

PO BOX 718
LIVINGSTON NJ
07039-0718
US

V. Phone/Fax

Practice location:
  • Phone: 914-737-9000
  • Fax:
Mailing address:
  • Phone: 973-740-0607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number205406-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: