Healthcare Provider Details

I. General information

NPI: 1083813646
Provider Name (Legal Business Name): NANCY GEYGAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 OAK ST
GARDEN CITY NY
11530-6543
US

IV. Provider business mailing address

PO BOX 798
ROCKVILLE CENTRE NY
11571-0798
US

V. Phone/Fax

Practice location:
  • Phone: 516-705-1353
  • Fax:
Mailing address:
  • Phone: 516-705-1353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number029019R
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: