Healthcare Provider Details

I. General information

NPI: 1932294535
Provider Name (Legal Business Name): PETER LEVINE GELLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 W 51ST ST SUITE 380
NEW YORK NY
10019-6113
US

IV. Provider business mailing address

PO BOX 27036
NEW YORK NY
10087-7036
US

V. Phone/Fax

Practice location:
  • Phone: 212-326-5547
  • Fax: 212-326-5549
Mailing address:
  • Phone: 212-326-5547
  • Fax: 212-326-5549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number162353
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: