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General NPI Number Information
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NPI Number | 1609015403
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Entity Type | Organization
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Legal Business Name | ANDREW LEE GELLER, C.S.W., P.C.
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 312 W 34TH ST PENTHOUSE A-3
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City | NEW YORK
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State | NY
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Zip | 10001-2401
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Country | US
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Telephone | 212-947-7111
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Fax | 212-239-0948
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Provider Business Mailing Address
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Address Line | 515 E 85TH ST 6B
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City | NEW YORK
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State | NY
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Zip | 10028-7421
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Country | US
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Telephone | 917-806-7532
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW LEE GELLER
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Credential | LCSW
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Telephone | 917-806-7532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R040501-1
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License Number State | NY
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