Healthcare Provider Details

I. General information

NPI: 1740482728
Provider Name (Legal Business Name): HANNAH L. GELLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HANNAH LATYSHEV PH.D.

II. Dates (important events)

Enumeration Date: 06/03/2007
Last Update Date: 03/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W 34TH ST PH FLOOR
NEW YORK NY
10001-3006
US

IV. Provider business mailing address

19 W 34TH ST PH FLOOR
NEW YORK NY
10001-3006
US

V. Phone/Fax

Practice location:
  • Phone: 646-479-4660
  • Fax: 646-871-0150
Mailing address:
  • Phone: 646-479-4660
  • Fax: 646-871-0150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number019478
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: