Healthcare Provider Details

I. General information

NPI: 1093809949
Provider Name (Legal Business Name): JOSEF JONATHAN GELDWERT D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 01/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 88TH ST
NEW YORK NY
10128-1111
US

IV. Provider business mailing address

111 E 88TH ST
NEW YORK NY
10128-1111
US

V. Phone/Fax

Practice location:
  • Phone: 212-996-1900
  • Fax: 212-996-2110
Mailing address:
  • Phone: 212-996-1900
  • Fax: 212-996-2110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberNO2528
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: