Healthcare Provider Details

I. General information

NPI: 1659390433
Provider Name (Legal Business Name): BARNETT PAUL GELLER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BROADWAY MEWS
HEWLETT NY
11557-2005
US

IV. Provider business mailing address

22 BROADWAY MEWS
HEWLETT NY
11557-2005
US

V. Phone/Fax

Practice location:
  • Phone: 516-295-4200
  • Fax:
Mailing address:
  • Phone: 516-295-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number033121
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: