Healthcare Provider Details

I. General information

NPI: 1194836387
Provider Name (Legal Business Name): STEVEN M GELLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3998 RED LION ROAD SUITE 250
PHILADELPHIA PA
19114
US

IV. Provider business mailing address

3998 RED LION ROAD SUITE 250
PHILADELPHIA PA
19114
US

V. Phone/Fax

Practice location:
  • Phone: 215-612-8500
  • Fax: 215-612-2893
Mailing address:
  • Phone: 215-612-8500
  • Fax: 215-612-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number050066302
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: