Healthcare Provider Details

I. General information

NPI: 1841288487
Provider Name (Legal Business Name): CAROL GEISLER CP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W 13TH ST 3
NEW YORK NY
10011-7700
US

IV. Provider business mailing address

100 SULLIVAN ST APT 4A
NEW YORK NY
10012-3625
US

V. Phone/Fax

Practice location:
  • Phone: 212-966-0958
  • Fax:
Mailing address:
  • Phone: 212-966-0958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number007571
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: