Healthcare Provider Details

I. General information

NPI: 1720158520
Provider Name (Legal Business Name): BIBIANA GELLER LCSW, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 WARREN ST
HASTINGS ON HUDSON NY
10706-3945
US

IV. Provider business mailing address

21 WARREN ST
HASTINGS ON HUDSON NY
10706-3945
US

V. Phone/Fax

Practice location:
  • Phone: 646-245-3168
  • Fax:
Mailing address:
  • Phone: 646-245-3168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number076515-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: