Healthcare Provider Details

I. General information

NPI: 1083650758
Provider Name (Legal Business Name): JEFFREY GELLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FORT WASHINGTON AVE 2ND FLOOR
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

PO BOX 26691
NEW YORK NY
10087-6691
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-4565
  • Fax:
Mailing address:
  • Phone: 212-305-7319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA07198
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number235464
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: