Healthcare Provider Details

I. General information

NPI: 1205825395
Provider Name (Legal Business Name): GEOFFREY JOSEPH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8775 NORWIN AVE SUITE C
NORTH HUNTINGDON PA
15642-2718
US

IV. Provider business mailing address

520 JEFFERSON AVE SUITE 400
JEANNETTE PA
15644-2538
US

V. Phone/Fax

Practice location:
  • Phone: 724-765-1163
  • Fax: 724-765-1173
Mailing address:
  • Phone: 724-527-8060
  • Fax: 724-522-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD041126E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: