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General NPI Number Information
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NPI Number | 1699099168
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Entity Type | Individual
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Provider Name | GEDDES SEAN GIBBS SIFI, LMSW, MSOL
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Gender | Male
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 03/26/2010
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Provider Practice Location Address
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Address Line | 19 W 34TH ST PH
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 917-714-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 18 ORCHARD VIEW DR
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City | EFFORT
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State | PA
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Zip | 18330-9083
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Country | US
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Telephone | 917-714-1555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 068627
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License Number State | NY
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