Healthcare Provider Details

I. General information

NPI: 1730383779
Provider Name (Legal Business Name): KEVIN T.C. GEFFE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PLAZA CT
EAST STROUDSBURG PA
18301-8262
US

IV. Provider business mailing address

2100 MACK BLVD FL 4
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 570-426-2301
  • Fax: 570-426-2306
Mailing address:
  • Phone: 570-501-6368
  • Fax: 302-449-9661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC2-0010031
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS017980
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: