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General NPI Number Information
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NPI Number | 1407132020
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Entity Type | Organization
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Legal Business Name | GELLER HOUSE
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 77 CHICAGO AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3757
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Country | US
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Telephone | 718-448-7828
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Fax |
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Provider Business Mailing Address
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Address Line | 180 TRANTOR PL 3C
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1959
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Country | US
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Telephone | 917-324-5015
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BERYL KENDE
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Credential |
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Telephone | 718-442-7828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 592180
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License Number State | NY
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