Healthcare Provider Details

I. General information

NPI: 1699240028
Provider Name (Legal Business Name): MARY GEDAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 10/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 PHILLIPS HILL RD
NEW CITY NY
10956-4114
US

IV. Provider business mailing address

50 RAILROAD AVE
PEARL RIVER NY
10965-1858
US

V. Phone/Fax

Practice location:
  • Phone: 845-639-2425
  • Fax:
Mailing address:
  • Phone: 845-274-3491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: